How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,288 to $9,772Professionalmedian $1,380 · 10th to 90th $912 to $1,585
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 $1,737.80 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,737.80 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,445.44 Typical High $1,445.44 | Professional | None | $758.58 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $2,187.76 | $4,897.79 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,380.38 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $1,737.80 Typical High $8,709.64 | Facility | None | $912.01 | $1,737.80 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $1,737.80 | Professional | None | $912.01 | $1,445.44 | $1,737.80 |
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 $1,047.13 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,047.13 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $10,715.19 | Facility | None | $5,495.41 | $8,317.64 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,445.44 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $7,943.28 | Facility | None | $602.56 | $616.60 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,862.09 | Professional | None | $602.56 | $724.44 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,548.82 | Professional | None | $776.25 | $1,047.13 | $1,548.82 |
21 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 $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $181.97 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $91.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,174.90 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,174.90 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $144.54 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $831.76 Typical High $891.25 | Professional | 62 · Two surgeons | $741.31 | $831.76 | $891.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,412.54 Median $1,584.89 Typical High $1,698.24 | Professional | 63 · Small infant | $1,412.54 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 80 · Assistant surgeon | $190.55 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $190.55 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $181.97 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $138.04 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $91.20 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,023.29 |
Where Idaho sits
The same service costs 4.4 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 $9,724MT $2,195
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.