How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,445 to $10,965Professionalmedian $1,479 · 10th to 90th $1,072 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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $5,128.61 Typical High $12,022.64 | Facility | None | $3,162.28 | $5,128.61 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,548.82 | $1,698.24 |
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 $1,023.29 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,174.90 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $5,495.41 | Facility | None | $691.83 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,737.80 | $1,995.26 |
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 $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 $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,698.24 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $741.31 | Facility | None | $691.83 | $691.83 | $741.31 |
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 $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,819.70 | Professional | None | $933.25 | $1,288.25 | $1,819.70 |
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 $537.03 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $537.03 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $213.80 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $794.33 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $162.18 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $107.15 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $741.31 | $1,202.26 | $1,202.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $8,128.31 Typical High $18,197.01 | Facility | 50 · Both sides | $4,786.30 | $8,128.31 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | 50 · Both sides | $1,995.26 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $933.25 Typical High $1,000.00 | Professional | 62 · Two surgeons | $831.76 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 63 · Small infant | $1,584.89 | $1,778.28 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $213.80 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $204.17 Typical High $218.78 | Professional | AS · PA/NP assist | $181.97 | $204.17 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $537.03 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $213.80 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $794.33 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $162.18 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $107.15 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $741.31 | $1,202.26 | $1,202.26 |
Where Idaho sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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
AL $11,256KY $2,261
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.