How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,259 to $7,762Professionalmedian $1,148 · 10th to 90th $776 to $1,318
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 $4,677.35 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $776.25 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,630.78 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,230.27 | Professional | None | $977.24 | $1,148.15 | $1,230.27 |
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 $758.58 Median $851.14 Typical High $977.24 | Professional | None | $758.58 | $851.14 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,698.24 Typical High $5,495.41 | Facility | None | $741.31 | $1,698.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,445.44 | Professional | None | $776.25 | $1,258.93 | $1,445.44 |
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 $851.14 Median $1,202.26 Typical High $1,202.26 | Facility | None | $851.14 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,202.26 | $1,445.44 |
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 $1,071.52 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,202.26 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $6,309.57 | Facility | None | $501.19 | $512.86 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,862.09 | Professional | None | $501.19 | $602.56 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,318.26 | Professional | None | $676.08 | $933.25 | $1,318.26 |
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 $389.05 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $389.05 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $154.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $77.62 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $870.96 | $870.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,090.30 Median $5,011.87 Typical High $12,589.25 | Facility | 50 · Both sides | $3,090.30 | $5,011.87 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,698.24 Typical High $1,862.09 | Professional | 50 · Both sides | $1,479.11 | $1,698.24 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $123.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $707.95 Typical High $776.25 | Professional | 62 · Two surgeons | $616.60 | $707.95 | $776.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,348.96 Typical High $1,479.11 | Professional | 63 · Small infant | $1,174.90 | $1,348.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $794.33 | $851.14 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $154.88 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $165.96 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $389.05 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $154.88 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $77.62 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $870.96 | $870.96 |
Where Idaho sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.