How much rates vary
Facilitymedian $339 · 10th to 90th $155 to $4,169Professionalmedian $468 · 10th to 90th $339 to $603
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 $338.84 Median $537.03 Typical High $602.56 | Professional | None | $338.84 | $537.03 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $251.19 Typical High $4,168.69 | Facility | None | $109.65 | $251.19 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $562.34 | Professional | None | $407.38 | $478.63 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $245.47 | Facility | None | $162.18 | $181.97 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $457.09 | Professional | None | $323.59 | $407.38 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $602.56 Typical High $5,495.41 | Facility | None | $245.47 | $602.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $645.65 | Professional | None | $363.08 | $537.03 | $645.65 |
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 $416.87 Median $436.52 Typical High $512.86 | Facility | None | $416.87 | $436.52 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $645.65 | Professional | None | $436.52 | $512.86 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $724.44 | Professional | None | $446.68 | $524.81 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $380.19 | Facility | None | $245.47 | $245.47 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $363.08 | Professional | None | $165.96 | $245.47 | $363.08 |
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 $281.84 Median $389.05 Typical High $575.44 | Professional | None | $281.84 | $389.05 | $575.44 |
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 $169.82 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $169.82 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $67.61 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $251.19 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $50.12 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $416.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $426.58 | $512.86 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $54.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $478.63 Median $575.44 Typical High $691.83 | Professional | 63 · Small infant | $478.63 | $575.44 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $398.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $75.86 Typical High $89.13 | Professional | 80 · Assistant surgeon | $64.57 | $75.86 | $89.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $77.62 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $66.07 | $77.62 | $89.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $75.86 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $75.86 | $89.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $64.57 Typical High $74.13 | Professional | AS · PA/NP assist | $61.66 | $64.57 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $169.82 | $269.15 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $67.61 | $107.15 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $251.19 | $398.11 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $50.12 | $81.28 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $371.54 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $436.52 |
Where Idaho sits
The same service costs 10.5 times more in Colorado 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
CO $4,157FL $396
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.