How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,445 to $8,318Professionalmedian $1,445 · 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 $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 $1,047.13 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,890.45 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,348.96 | $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 $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | None | $954.99 | $1,122.02 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $5,495.41 | Facility | None | $812.83 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,621.81 | $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 $1,174.90 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 $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $6,309.57 | Facility | None | $691.83 | $707.95 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,862.09 | Professional | None | $691.83 | $812.83 | $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 $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 $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $524.81 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $104.71 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $5,754.40 Typical High $12,589.25 | Facility | 50 · Both sides | $3,311.31 | $5,754.40 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,238.72 Typical High $2,454.71 | Professional | 50 · Both sides | $2,041.74 | $2,238.72 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $162.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $933.25 Typical High $1,023.29 | Professional | 62 · Two surgeons | $851.14 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,621.81 Median $1,819.70 Typical High $1,949.84 | Professional | 63 · Small infant | $1,621.81 | $1,819.70 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $263.03 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $263.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $239.88 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $213.80 | $239.88 | $263.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $239.88 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $239.88 | $263.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | AS · PA/NP assist | $181.97 | $204.17 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $524.81 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $104.71 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 3.1 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 $8,115MD $2,591
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.