How much rates vary
Facilitymedian $2,188 · 10th to 90th $759 to $7,762Professionalmedian $832 · 10th to 90th $562 to $1,202
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,174.90 | Professional | None | $524.81 | $831.76 | $1,174.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,041.74 Median $3,548.13 Typical High $8,511.38 | Facility | None | $2,041.74 | $3,548.13 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,202.26 | Professional | None | $707.95 | $912.01 | $1,202.26 |
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 $524.81 Median $645.65 Typical High $912.01 | Professional | None | $524.81 | $645.65 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $5,495.41 | Facility | None | $363.08 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,174.90 | Professional | None | $630.96 | $954.99 | $1,174.90 |
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 $758.58 Median $758.58 Typical High $1,122.02 | Facility | None | $758.58 | $758.58 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,412.54 | Professional | None | $758.58 | $954.99 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,348.96 | Professional | None | $831.76 | $977.24 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $6,309.57 | Facility | None | $537.03 | $537.03 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $1,862.09 | Professional | None | $407.38 | $537.03 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,047.13 | Professional | None | $436.52 | $660.69 | $1,047.13 |
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 $257.04 Median $416.87 Typical High $588.84 | Professional | 52 · Reduced service | $257.04 | $416.87 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $165.96 Typical High $234.42 | Professional | 53 · Discontinued | $104.71 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $630.96 Typical High $870.96 | Professional | 54 · Surgery only | $389.05 | $630.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 55 · Aftercare only | $77.62 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $83.18 Typical High $117.49 | Professional | 56 · Pre-op care only | $52.48 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $588.84 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $363.08 | $588.84 | $812.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $1,096.48 | Professional | 54 · Surgery only | $630.96 | $758.58 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $100.00 Typical High $125.89 | Professional | 55 · Aftercare only | $69.18 | $100.00 | $125.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $831.76 Median $1,023.29 Typical High $1,513.56 | Professional | 63 · Small infant | $831.76 | $1,023.29 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $162.18 Typical High $199.53 | Professional | 80 · Assistant surgeon | $112.20 | $162.18 | $199.53 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $131.83 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $112.20 | $131.83 | $190.55 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $134.90 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $134.90 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $114.82 Typical High $158.49 | Professional | AS · PA/NP assist | $97.72 | $114.82 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $416.87 Typical High $588.84 | Professional | 52 · Reduced service | $257.04 | $416.87 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $165.96 Typical High $234.42 | Professional | 53 · Discontinued | $104.71 | $165.96 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $630.96 Typical High $870.96 | Professional | 54 · Surgery only | $389.05 | $630.96 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 55 · Aftercare only | $77.62 | $125.89 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $83.18 Typical High $117.49 | Professional | 56 · Pre-op care only | $52.48 | $83.18 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $588.84 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $363.08 | $588.84 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $645.65 | $645.65 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $125.89 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $954.99 |
Where Idaho sits
The same service costs 5.8 times more in Alabama than in Montana. 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 $8,423MT $1,458
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.