How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,230 to $17,378Professionalmedian $1,349 · 10th to 90th $813 to $2,138
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 $1,445.44 Median $2,454.71 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,454.71 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,230.27 Typical High $2,041.74 | Professional | None | $741.31 | $1,230.27 | $2,041.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,570.40 Median $8,912.51 Typical High $18,620.87 | Facility | None | $2,570.40 | $8,912.51 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,548.82 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $5,248.07 | $5,888.44 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $19,498.45 | Facility | None | $891.25 | $2,137.96 | $19,498.45 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,344.23 | Professional | None | $933.25 | $1,445.44 | $2,344.23 |
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 $1,096.48 Median $1,995.26 Typical High $8,912.51 | Facility | None | $1,096.48 | $1,995.26 | $8,912.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,380.38 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,445.44 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $977.24 Typical High $5,888.44 | Facility | None | $954.99 | $977.24 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $5,370.32 | Professional | None | $616.60 | $954.99 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $3,090.30 | Facility | None | $1,412.54 | $1,862.09 | $3,090.30 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,819.70 | Professional | None | $676.08 | $1,096.48 | $1,819.70 |
28 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 $371.54 Median $602.56 Typical High $1,023.29 | Professional | 52 · Reduced service | $371.54 | $602.56 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $245.47 Typical High $416.87 | Professional | 53 · Discontinued | $147.91 | $245.47 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $912.01 Typical High $1,548.82 | Professional | 54 · Surgery only | $562.34 | $912.01 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $181.97 Typical High $309.03 | Professional | 55 · Aftercare only | $112.20 | $181.97 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $123.03 Typical High $204.17 | Professional | 56 · Pre-op care only | $74.13 | $123.03 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $851.14 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $524.81 | $851.14 | $1,445.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $13,489.63 Typical High $28,183.83 | Facility | 50 · Both sides | $3,801.89 | $13,489.63 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,995.26 Typical High $3,311.31 | Professional | 50 · Both sides | $1,513.56 | $1,995.26 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,737.80 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $104.71 | $181.97 | $218.78 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $954.99 Typical High $1,412.54 | Professional | 62 · Two surgeons | $630.96 | $954.99 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,445.44 Typical High $2,691.53 | Professional | 63 · Small infant | $1,230.27 | $1,445.44 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $870.96 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $741.31 | $870.96 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $354.81 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $354.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $213.80 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $162.18 | $213.80 | $346.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $213.80 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $213.80 | $346.74 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $295.12 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $602.56 Typical High $1,023.29 | Professional | 52 · Reduced service | $371.54 | $602.56 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $245.47 Typical High $416.87 | Professional | 53 · Discontinued | $147.91 | $245.47 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $912.01 Typical High $1,548.82 | Professional | 54 · Surgery only | $562.34 | $912.01 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $181.97 Typical High $309.03 | Professional | 55 · Aftercare only | $112.20 | $181.97 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $123.03 Typical High $204.17 | Professional | 56 · Pre-op care only | $74.13 | $123.03 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $851.14 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $524.81 | $851.14 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $1,995.26 Typical High $3,388.44 | Professional | 50 · Both sides | $1,995.26 | $1,995.26 | $3,388.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,548.82 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $831.76 Typical High $1,412.54 | Professional | 62 · Two surgeons | $831.76 | $831.76 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,659.59 |
Where Idaho sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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
AK $10,217WV $2,002
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.