How much rates vary
Facilitymedian $2,188 · 10th to 90th $955 to $7,762Professionalmedian $912 · 10th to 90th $562 to $1,072
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 $588.84 Median $912.01 Typical High $912.01 | Professional | None | $588.84 | $912.01 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,548.13 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,548.13 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $954.99 | Professional | None | $776.25 | $912.01 | $954.99 |
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 $537.03 Median $630.96 Typical High $707.95 | Professional | None | $537.03 | $630.96 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $5,495.41 | Facility | None | $489.78 | $912.01 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,096.48 | Professional | None | $588.84 | $912.01 | $1,096.48 |
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 $691.83 Median $954.99 Typical High $954.99 | Facility | None | $691.83 | $954.99 | $954.99 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | None | $954.99 | $954.99 | $1,071.52 |
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 $912.01 Typical High $1,096.48 | Professional | None | $831.76 | $912.01 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $6,309.57 | Facility | None | $407.38 | $407.38 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $1,862.09 | Professional | None | $407.38 | $457.09 | $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 $478.63 Median $660.69 Typical High $954.99 | Professional | None | $478.63 | $660.69 | $954.99 |
22 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 $295.12 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $295.12 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $117.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $436.52 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $87.10 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $58.88 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $407.38 | $645.65 | $645.65 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,090.30 Median $4,897.79 Typical High $12,589.25 | Facility | 50 · Both sides | $3,090.30 | $4,897.79 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | 50 · Both sides | $1,174.90 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $812.83 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $95.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,071.52 Typical High $1,148.15 | Professional | 63 · Small infant | $933.25 | $1,071.52 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $630.96 | $660.69 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $144.54 Typical High $151.36 | Professional | 80 · Assistant surgeon | $125.89 | $144.54 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $144.54 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $125.89 | $144.54 | $151.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $144.54 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $144.54 | $151.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $123.03 Typical High $128.82 | Professional | AS · PA/NP assist | $107.15 | $123.03 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $295.12 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $117.49 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $436.52 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $87.10 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $58.88 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $407.38 | $645.65 | $645.65 |
Where Idaho sits
The same service costs 4.9 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 $7,341MT $1,483
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.