How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,096 to $7,762Professionalmedian $1,047 · 10th to 90th $661 to $1,230
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 $562.34 Median $1,071.52 Typical High $1,071.52 | Professional | None | $562.34 | $1,071.52 | $1,071.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,235.94 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | None | $891.25 | $1,047.13 | $1,096.48 |
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 $630.96 Median $724.44 Typical High $831.76 | Professional | None | $630.96 | $724.44 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,071.52 Typical High $5,495.41 | Facility | None | $588.84 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,258.93 | Professional | None | $676.08 | $1,071.52 | $1,258.93 |
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 $794.33 Median $1,096.48 Typical High $1,096.48 | Facility | None | $794.33 | $1,096.48 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,096.48 | $1,258.93 |
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 $954.99 Median $1,071.52 Typical High $1,258.93 | Professional | None | $954.99 | $1,071.52 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $5,128.61 | Facility | None | $467.74 | $467.74 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,862.09 | Professional | None | $467.74 | $524.81 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,818.38 | Facility | None | $1,412.54 | $1,819.70 | $2,818.38 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,122.02 | Professional | None | $562.34 | $758.58 | $1,122.02 |
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 $338.84 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $338.84 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $134.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $512.86 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $67.61 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $478.63 | $758.58 | $758.58 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,090.30 Median $4,786.30 Typical High $12,589.25 | Facility | 50 · Both sides | $3,090.30 | $4,786.30 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,548.82 Typical High $1,621.81 | Professional | 50 · Both sides | $1,348.96 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $109.65 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $645.65 Typical High $676.08 | Professional | 62 · Two surgeons | $562.34 | $645.65 | $676.08 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | 63 · Small infant | $1,071.52 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $758.58 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 80 · Assistant surgeon | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $141.25 Typical High $147.91 | Professional | AS · PA/NP assist | $123.03 | $141.25 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $338.84 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $134.90 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $512.86 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $67.61 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $478.63 | $758.58 | $758.58 |
Where Idaho sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.