How much rates vary
Facilitymedian $4,074 · 10th to 90th $550 to $19,055Professionalmedian $8,511 · 10th to 90th $5,012 to $11,482
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $11,481.54 Typical High $11,481.54 | Professional | None | $4,677.35 | $11,481.54 | $11,481.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $17,782.79 Median $19,054.61 Typical High $22,908.68 | Facility | None | $17,782.79 | $19,054.61 | $22,908.68 |
BCBS Idaho Setting Professional Modifier None Typical Low $7,762.47 Median $9,120.11 Typical High $9,549.93 | Professional | None | $7,762.47 | $9,120.11 | $9,549.93 |
Moda Health Setting Facility Modifier None Typical Low $3,981.07 Median $6,309.57 Typical High $16,218.10 | Facility | None | $3,981.07 | $6,309.57 | $16,218.10 |
Moda Health Setting Professional Modifier None Typical Low $6,309.57 Median $8,912.51 Typical High $11,481.54 | Professional | None | $6,309.57 | $8,912.51 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6,918.31 Median $8,511.38 Typical High $8,511.38 | Facility | None | $6,918.31 | $8,511.38 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,511.38 | $8,709.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,317.64 Median $9,549.93 Typical High $9,772.37 | Professional | None | $8,317.64 | $9,549.93 | $9,772.37 |
Select Health Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,365.16 | Facility | None | $4,073.80 | $4,073.80 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,073.80 | $5,888.44 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $7,244.36 Typical High $10,471.29 | Professional | None | $4,365.16 | $7,244.36 | $10,471.29 |
21 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 $2,754.23 Median $5,754.40 Typical High $5,754.40 | Professional | 52 · Reduced service | $2,754.23 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $2,290.87 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,096.48 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $8,511.38 Typical High $8,511.38 | Professional | 54 · Surgery only | $4,073.80 | $8,511.38 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $1,737.80 Typical High $1,737.80 | Professional | 55 · Aftercare only | $812.83 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $1,148.15 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $549.54 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,801.89 Median $7,943.28 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $3,801.89 | $7,943.28 | $7,943.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $6,918.31 Median $7,762.47 Typical High $8,511.38 | Professional | 54 · Surgery only | $6,918.31 | $7,762.47 | $8,511.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $870.96 Typical High $954.99 | Professional | 55 · Aftercare only | $758.58 | $870.96 | $954.99 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $4,786.30 Median $5,370.32 Typical High $5,888.44 | Professional | 62 · Two surgeons | $4,786.30 | $5,370.32 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $9,120.11 Median $10,471.29 Typical High $11,481.54 | Professional | 63 · Small infant | $9,120.11 | $10,471.29 | $11,481.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,370.32 Median $6,025.60 Typical High $6,606.93 | Professional | 78 · Unplanned return to OR | $5,370.32 | $6,025.60 | $6,606.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 81 · Minimal assistant surgeon | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 82 · Assistant surgeon, no resident | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $1,047.13 Median $1,174.90 Typical High $1,288.25 | Professional | AS · PA/NP assist | $1,047.13 | $1,174.90 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,162.28 Median $5,754.40 Typical High $5,754.40 | Professional | 52 · Reduced service | $3,162.28 | $5,754.40 | $5,754.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,258.93 Median $2,290.87 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,258.93 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,786.30 Median $8,511.38 Typical High $8,511.38 | Professional | 54 · Surgery only | $4,786.30 | $8,511.38 | $8,511.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $954.99 Median $1,737.80 Typical High $1,737.80 | Professional | 55 · Aftercare only | $954.99 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $630.96 Median $1,148.15 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $630.96 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,466.84 Median $7,943.28 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $4,466.84 | $7,943.28 | $7,943.28 |
Where Idaho sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.