How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,514 to $8,318Professionalmedian $1,622 · 10th to 90th $1,096 to $1,995
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,467.37 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,778.28 | $1,819.70 |
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 $1,000.00 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,230.27 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $5,495.41 | Facility | None | $1,096.48 | $1,819.70 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,819.70 | $2,137.96 |
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 $1,318.26 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,318.26 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,621.81 | $2,041.74 |
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 $1,548.82 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,819.70 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $6,309.57 | Facility | None | $776.25 | $794.33 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,862.09 | Professional | None | $776.25 | $891.25 | $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 $933.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $933.25 | $1,258.93 | $1,862.09 |
20 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 $575.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $234.42 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $870.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $173.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $812.83 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $181.97 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,819.70 Median $2,041.74 Typical High $2,187.76 | Professional | 63 · Small infant | $1,819.70 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 80 · Assistant surgeon | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $251.19 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $234.42 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $870.96 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $173.78 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $114.82 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $812.83 | $1,258.93 | $1,258.93 |
Where Idaho sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.