How much rates vary
Facilitymedian $1,202 · 10th to 90th $562 to $4,898Professionalmedian $676 · 10th to 90th $447 to $1,122
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $1,122.02 Typical High $1,122.02 | Professional | None | $457.09 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $331.13 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $66.07 | $169.82 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $4,897.79 | Facility | None | $1,122.02 | $1,548.82 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $758.58 | Professional | None | $616.60 | $724.44 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $630.96 | $676.08 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,513.56 | Facility | None | $977.24 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $645.65 | Professional | None | $467.74 | $549.54 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,122.02 Typical High $5,495.41 | Facility | None | $457.09 | $1,122.02 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,122.02 | Professional | None | $524.81 | $741.31 | $1,122.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $389.05 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $77.62 | $169.82 | $169.82 |
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 $537.03 Median $660.69 Typical High $660.69 | Facility | None | $537.03 | $660.69 | $660.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | None | $660.69 | $660.69 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,162.28 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $3,311.31 | Facility | None | $316.23 | $323.59 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $724.44 | Professional | None | $316.23 | $316.23 | $724.44 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $812.83 | Professional | None | $416.87 | $549.54 | $812.83 |
16 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 $218.78 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $218.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $89.13 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $44.67 | $112.20 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $724.44 Median $851.14 Typical High $891.25 | Professional | 63 · Small infant | $724.44 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $524.81 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 80 · Assistant surgeon | $97.72 | $112.20 | $120.23 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $97.72 | $112.20 | $120.23 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $97.72 | $112.20 | $120.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $95.50 Typical High $102.33 | Professional | AS · PA/NP assist | $83.18 | $95.50 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $263.03 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $104.71 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $52.48 | $112.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 22 · Increased work | $812.83 | $812.83 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 63 · Small infant | $812.83 | $812.83 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Idaho sits
The same service costs 3.8 times more in Colorado than in Delaware. 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
CO $4,403DE $1,156
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.