How much rates vary
Facilitymedian $355 · 10th to 90th $151 to $933Professionalmedian $933 · 10th to 90th $589 to $1,096
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $1,000.00 | Professional | None | $537.03 | $933.25 | $1,000.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $616.60 | Facility | None | $144.54 | $234.42 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,122.02 | Professional | None | $794.33 | $933.25 | $1,122.02 |
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 $537.03 Median $660.69 Typical High $758.58 | Professional | None | $537.03 | $660.69 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $5,495.41 | Facility | None | $489.78 | $933.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,096.48 | Professional | None | $645.65 | $933.25 | $1,096.48 |
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 $870.96 Typical High $1,023.29 | Facility | None | $851.14 | $870.96 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,288.25 | Professional | None | $870.96 | $1,023.29 | $1,288.25 |
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 $851.14 Median $1,000.00 Typical High $1,174.90 | Professional | None | $851.14 | $1,000.00 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $501.19 | Facility | None | $302.00 | $489.78 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $489.78 Typical High $707.95 | Professional | None | $151.36 | $489.78 | $707.95 |
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 $478.63 Median $660.69 Typical High $954.99 | Professional | None | $478.63 | $660.69 | $954.99 |
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 $295.12 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $295.12 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $117.49 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $446.68 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $89.13 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $58.88 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $691.83 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $218.78 Median $346.74 Typical High $1,071.52 | Facility | 50 · Both sides | $218.78 | $346.74 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $1,698.24 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $741.31 | $870.96 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $97.72 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,148.15 Typical High $1,318.26 | Professional | 63 · Small infant | $954.99 | $1,148.15 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $676.08 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $676.08 | $776.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 80 · Assistant surgeon | $131.83 | $151.36 | $177.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $151.36 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $128.82 | $151.36 | $177.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $151.36 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $151.36 | $186.21 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $158.49 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $295.12 | $467.74 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $117.49 | $186.21 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $446.68 | $691.83 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $89.13 | $138.04 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $58.88 | $93.33 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,513.56 Typical High $1,621.81 | Professional | 50 · Both sides | $1,513.56 | $1,513.56 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $707.95 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $812.83 |
Where Idaho sits
The same service costs 4.9 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 $3,107FL $640
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.