How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,514 to $7,762Professionalmedian $1,514 · 10th to 90th $1,000 to $1,778
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 $1,071.52 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,659.59 | $1,659.59 |
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 $1,412.54 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,621.81 | $1,698.24 |
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 $891.25 Median $1,096.48 Typical High $1,258.93 | Professional | None | $891.25 | $1,096.48 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $5,495.41 | Facility | None | $954.99 | $1,659.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,659.59 | $1,905.46 |
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,230.27 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,513.56 | $1,905.46 |
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 $1,380.38 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,621.81 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $741.31 Typical High $6,309.57 | Facility | None | $724.44 | $741.31 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,862.09 | Professional | None | $724.44 | $794.33 | $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 $812.83 Median $1,096.48 Typical High $1,584.89 | Professional | None | $812.83 | $1,096.48 | $1,584.89 |
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 $537.03 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $213.80 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $794.33 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $158.49 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $107.15 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $741.31 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $169.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $1,862.09 Typical High $2,041.74 | Professional | 63 · Small infant | $1,698.24 | $1,862.09 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | 80 · Assistant surgeon | $223.87 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $223.87 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | AS · PA/NP assist | $190.55 | $213.80 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $213.80 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $794.33 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $158.49 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $107.15 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $741.31 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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 $7,619HI $2,493
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.