How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,380 to $14,125Professionalmedian $1,413 · 10th to 90th $871 to $2,291
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,290.87 | Professional | None | $912.01 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,513.56 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,318.26 | Professional | None | $933.25 | $1,122.02 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $5,495.41 | Facility | None | $891.25 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,513.56 | $2,290.87 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,122.02 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,380.38 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,584.89 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $10,715.19 | Facility | None | $660.69 | $676.08 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,479.11 | Professional | None | $660.69 | $660.69 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,659.59 | Professional | None | $851.14 | $1,096.48 | $1,659.59 |
27 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 $446.68 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $446.68 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $177.83 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $660.69 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $131.83 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $89.13 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $616.60 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,318.26 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $912.01 Typical High $954.99 | Professional | 62 · Two surgeons | $794.33 | $912.01 | $954.99 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | 63 · Small infant | $1,513.56 | $1,778.28 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $1,023.29 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 80 · Assistant surgeon | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | AS · PA/NP assist | $173.78 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $537.03 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $213.80 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $162.18 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $107.15 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $758.58 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 22 · Increased work | $1,698.24 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 62 · Two surgeons | $954.99 | $954.99 | $954.99 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 63 · Small infant | $1,698.24 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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
AK $9,771KY $2,053
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.