How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,479 to $16,982Professionalmedian $1,479 · 10th to 90th $1,023 to $1,820
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 $891.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $891.25 | $1,698.24 | $1,698.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $6,309.57 Typical High $18,620.87 | Facility | None | $2,290.87 | $6,309.57 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,621.81 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,288.25 | Professional | None | $954.99 | $1,122.02 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,698.24 Typical High $5,495.41 | Facility | None | $891.25 | $1,698.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,698.24 | $1,949.84 |
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 $1,202.26 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,202.26 | $1,479.11 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,479.11 | $1,862.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,659.59 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $7,585.78 | Facility | None | $707.95 | $724.44 | $7,585.78 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $4,168.69 | Professional | None | $707.95 | $831.76 | $4,168.69 |
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 $851.14 Median $1,174.90 Typical High $1,737.80 | Professional | None | $851.14 | $1,174.90 | $1,737.80 |
23 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 $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $104.71 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,174.90 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,467.37 Median $9,332.54 Typical High $28,183.83 | Facility | 50 · Both sides | $3,467.37 | $9,332.54 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,290.87 Typical High $2,511.89 | Professional | 50 · Both sides | $2,041.74 | $2,290.87 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $165.96 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $954.99 Typical High $1,047.13 | Professional | 62 · Two surgeons | $851.14 | $954.99 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,819.70 Typical High $1,995.26 | Professional | 63 · Small infant | $1,659.59 | $1,819.70 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 80 · Assistant surgeon | $218.78 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $218.78 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | AS · PA/NP assist | $186.21 | $208.93 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $104.71 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,174.90 |
Where Idaho sits
The same service costs 5.4 times more in Vermont 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
VT $13,505HI $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.