How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,445 to $8,318Professionalmedian $1,445 · 10th to 90th $933 to $1,660
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 $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,548.82 | $1,548.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,801.89 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,801.89 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,548.82 | $1,621.81 |
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 $831.76 Median $1,047.13 Typical High $1,174.90 | Professional | None | $831.76 | $1,047.13 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,548.82 Typical High $5,495.41 | Facility | None | $870.96 | $1,548.82 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,548.82 | $1,819.70 |
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 $1,174.90 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,445.44 | $1,819.70 |
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 $1,288.25 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,548.82 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $6,309.57 | Facility | None | $676.08 | $691.83 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,862.09 | Professional | None | $676.08 | $758.58 | $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 $741.31 Median $1,023.29 Typical High $1,513.56 | Professional | None | $741.31 | $1,023.29 | $1,513.56 |
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 $501.19 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $501.19 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $199.53 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $758.58 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $707.95 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,778.28 Typical High $1,905.46 | Professional | 63 · Small infant | $1,584.89 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 80 · Assistant surgeon | $213.80 | $234.42 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $213.80 | $234.42 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $234.42 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | AS · PA/NP assist | $177.83 | $199.53 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $501.19 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $199.53 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $758.58 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $100.00 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $707.95 | $1,096.48 | $1,096.48 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin than in Kansas. 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 $7,660KS $2,436
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.