How much rates vary
Facilitymedian $269 · 10th to 90th $170 to $676Professionalmedian $282 · 10th to 90th $186 to $501
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 Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $446.68 | Professional | None | $169.82 | $275.42 | $446.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $691.83 | Facility | None | $186.21 | $331.13 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $537.03 | Professional | None | $234.42 | $380.19 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $257.04 | Facility | None | $169.82 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $331.13 | Professional | None | $186.21 | $234.42 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $275.42 Typical High $630.96 | Facility | None | $144.54 | $275.42 | $630.96 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $446.68 | Professional | None | $218.78 | $323.59 | $446.68 |
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 $251.19 Median $251.19 Typical High $501.19 | Facility | None | $251.19 | $251.19 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $630.96 | Professional | None | $251.19 | $316.23 | $630.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $870.96 | Facility | None | $467.74 | $676.08 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $537.03 | Professional | None | $275.42 | $323.59 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $549.54 | Facility | None | $234.42 | $239.88 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $295.12 | Professional | None | $138.04 | $213.80 | $295.12 |
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 $147.91 Median $239.88 Typical High $416.87 | Professional | None | $147.91 | $239.88 | $416.87 |
19 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 $85.11 Median $138.04 Typical High $218.78 | Professional | 52 · Reduced service | $85.11 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $54.95 Typical High $89.13 | Professional | 53 · Discontinued | $34.67 | $54.95 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $40.74 Typical High $66.07 | Professional | 55 · Aftercare only | $25.70 | $40.74 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $27.54 Typical High $44.67 | Professional | 56 · Pre-op care only | $17.38 | $27.54 | $44.67 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $213.80 | $398.11 | $489.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $23.44 | $41.69 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $331.13 Typical High $630.96 | Professional | 63 · Small infant | $281.84 | $331.13 | $630.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $190.55 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $162.18 | $190.55 | $331.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $74.13 Typical High $89.13 | Professional | 80 · Assistant surgeon | $37.15 | $74.13 | $89.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $44.67 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $37.15 | $44.67 | $87.10 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $43.65 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $43.65 | $85.11 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.02 Typical High $72.44 | Professional | AS · PA/NP assist | $31.62 | $38.02 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $138.04 Typical High $218.78 | Professional | 52 · Reduced service | $85.11 | $138.04 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $54.95 Typical High $89.13 | Professional | 53 · Discontinued | $34.67 | $54.95 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $40.74 Typical High $66.07 | Professional | 55 · Aftercare only | $25.70 | $40.74 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $27.54 Typical High $44.67 | Professional | 56 · Pre-op care only | $17.38 | $27.54 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $354.81 | Professional | 54 · Surgery only | $213.80 | $213.80 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $50.12 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $380.19 |
Where Idaho sits
The same service costs 8.0 times more in New York than in Maryland. 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
NY $2,495MD $313
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.