How much rates vary
Facilitymedian $363 · 10th to 90th $151 to $1,047Professionalmedian $977 · 10th to 90th $646 to $1,148
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,047.13 | Professional | None | $645.65 | $1,023.29 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $707.95 | Facility | None | $144.54 | $263.03 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,148.15 | Professional | None | $851.14 | $1,023.29 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $794.33 | Professional | None | $588.84 | $707.95 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $5,495.41 | Facility | None | $501.19 | $1,023.29 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,202.26 | Professional | None | $660.69 | $1,023.29 | $1,202.26 |
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 $851.14 Median $912.01 Typical High $1,047.13 | Facility | None | $851.14 | $912.01 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,318.26 | Professional | None | $912.01 | $1,047.13 | $1,318.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | None | $870.96 | $1,023.29 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $501.19 Typical High $512.86 | Facility | None | $302.00 | $501.19 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $501.19 Typical High $776.25 | Professional | None | $151.36 | $501.19 | $776.25 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,071.52 | Professional | None | $524.81 | $724.44 | $1,071.52 |
26 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 $323.59 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $323.59 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $128.82 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $478.63 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $64.57 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $724.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $218.78 Median $380.19 Typical High $1,071.52 | Facility | 50 · Both sides | $218.78 | $380.19 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,479.11 Typical High $1,698.24 | Professional | 50 · Both sides | $1,288.25 | $1,479.11 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $794.33 | $912.01 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,023.29 Median $1,202.26 Typical High $1,348.96 | Professional | 63 · Small infant | $1,023.29 | $1,202.26 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $588.84 | $707.95 | $794.33 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $190.55 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $190.55 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $158.49 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $134.90 | $158.49 | $181.97 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $158.49 | $181.97 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $323.59 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $128.82 | $204.17 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $478.63 | $758.58 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $64.57 | $102.33 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $724.44 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $1,698.24 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $776.25 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $851.14 |
Where Idaho sits
The same service costs 5.2 times more in Connecticut than in Florida. 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
CT $3,486FL $668
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.