How much rates vary
Facilitymedian $363 · 10th to 90th $151 to $1,047Professionalmedian $977 · 10th to 90th $631 to $1,230
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 $630.96 Median $977.24 Typical High $1,047.13 | Professional | None | $630.96 | $977.24 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $707.95 | Facility | None | $154.88 | $257.04 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,288.25 | Professional | None | $912.01 | $1,047.13 | $1,288.25 |
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 $575.44 Median $724.44 Typical High $831.76 | Professional | None | $575.44 | $724.44 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $5,495.41 | Facility | None | $512.86 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,230.27 | Professional | None | $691.83 | $1,023.29 | $1,230.27 |
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 $954.99 Median $1,000.00 Typical High $1,174.90 | Facility | None | $954.99 | $1,000.00 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,174.90 | $1,479.11 |
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 $891.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $891.25 | $1,047.13 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $562.34 Typical High $575.44 | Facility | None | $281.84 | $562.34 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $562.34 Typical High $741.31 | Professional | None | $151.36 | $562.34 | $741.31 |
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 $512.86 Median $707.95 Typical High $1,023.29 | Professional | None | $512.86 | $707.95 | $1,023.29 |
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 $316.23 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $316.23 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $125.89 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $478.63 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $95.50 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $741.31 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $234.42 Median $380.19 Typical High $1,071.52 | Facility | 50 · Both sides | $234.42 | $380.19 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,621.81 Typical High $1,905.46 | Professional | 50 · Both sides | $1,288.25 | $1,621.81 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,071.52 Median $1,318.26 Typical High $1,584.89 | Professional | 63 · Small infant | $1,071.52 | $1,318.26 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $933.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $204.17 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $169.82 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $144.54 | $169.82 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $173.78 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $173.78 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $169.82 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $316.23 | $489.78 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $125.89 | $194.98 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $478.63 | $724.44 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $95.50 | $144.54 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | 50 · Both sides | $1,584.89 | $1,584.89 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $741.31 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $114.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $870.96 |
Where Idaho sits
The same service costs 5.2 times more in Connecticut than in Delaware. 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 $3,468DE $666
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.