How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,148 to $7,762Professionalmedian $1,175 · 10th to 90th $794 to $1,445
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | None | $831.76 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,715.35 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,715.35 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,258.93 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,000.00 | Professional | None | $758.58 | $891.25 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $5,495.41 | Facility | None | $758.58 | $1,318.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,548.82 | Professional | None | $831.76 | $1,318.26 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,318.26 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $6,309.57 | Facility | None | $549.54 | $562.34 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,862.09 | Professional | None | $549.54 | $645.65 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,380.38 | Professional | None | $691.83 | $933.25 | $1,380.38 |
22 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $416.87 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $83.18 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $912.01 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $5,370.32 Typical High $12,589.25 | Facility | 50 · Both sides | $3,311.31 | $5,370.32 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 50 · Both sides | $1,584.89 | $1,778.28 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,288.25 Median $1,412.54 Typical High $1,548.82 | Professional | 63 · Small infant | $1,288.25 | $1,412.54 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $912.01 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | 80 · Assistant surgeon | $169.82 | $190.55 | $208.93 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $169.82 | $190.55 | $208.93 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $190.55 | $208.93 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $162.18 Typical High $173.78 | Professional | AS · PA/NP assist | $144.54 | $162.18 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $416.87 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $165.96 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $83.18 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $912.01 |
Where Idaho sits
The same service costs 3.7 times more in Wisconsin than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $7,647MT $2,070
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.