How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $7,762Professionalmedian $1,622 · 10th to 90th $955 to $1,905
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 $1,230.27 Median $2,884.03 Typical High $7,762.47 | Facility | None | $1,230.27 | $2,884.03 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,698.24 Typical High $1,698.24 | Professional | None | $851.14 | $1,698.24 | $1,698.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,801.89 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,621.81 | $1,698.24 |
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 $1,000.00 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,148.15 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $4,466.84 Typical High $7,762.47 | Facility | None | $1,071.52 | $4,466.84 | $7,762.47 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,698.24 | $1,995.26 |
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 $1,230.27 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,230.27 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,737.80 | $1,995.26 |
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 $1,445.44 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,698.24 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $5,888.44 | Facility | None | $724.44 | $724.44 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,862.09 | Professional | None | $724.44 | $851.14 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,412.54 | $1,819.70 | $3,235.94 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,778.28 | Professional | None | $891.25 | $1,202.26 | $1,778.28 |
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 $537.03 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $537.03 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $812.83 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $162.18 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $107.15 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $758.58 | $1,202.26 | $1,202.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $5,623.41 Typical High $12,589.25 | Facility | 50 · Both sides | $3,311.31 | $5,623.41 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,398.83 Typical High $2,570.40 | Professional | 50 · Both sides | $2,089.30 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $169.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,905.46 Typical High $2,041.74 | Professional | 63 · Small infant | $1,659.59 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 80 · Assistant surgeon | $223.87 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $223.87 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | AS · PA/NP assist | $190.55 | $218.78 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $537.03 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $812.83 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $162.18 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $107.15 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $758.58 | $1,202.26 | $1,202.26 |
Where Idaho sits
The same service costs 3.2 times more in Wisconsin 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
WI $8,354MD $2,629
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.