How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,622 to $14,125Professionalmedian $1,047 · 10th to 90th $603 to $1,622
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 $891.25 Median $1,949.84 Typical High $6,918.31 | Facility | None | $891.25 | $1,949.84 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $1,621.81 Typical High $1,621.81 | Professional | None | $537.03 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,981.07 Median $6,309.57 Typical High $14,791.08 | Facility | None | $3,981.07 | $6,309.57 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,174.90 | Professional | None | $954.99 | $1,096.48 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $933.25 | Professional | None | $660.69 | $794.33 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $6,918.31 Typical High $13,803.84 | Facility | None | $891.25 | $6,918.31 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,621.81 | Professional | None | $575.44 | $1,071.52 | $1,621.81 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,047.13 | $1,096.48 |
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 $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | None | $977.24 | $1,148.15 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $10,232.93 | Facility | None | $501.19 | $501.19 | $10,232.93 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,047.13 | Professional | None | $501.19 | $501.19 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,174.90 | Professional | None | $602.56 | $776.25 | $1,174.90 |
30 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 $316.23 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $316.23 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $125.89 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $467.74 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $95.50 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $63.10 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $436.52 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $9,120.11 Typical High $22,387.21 | Facility | 50 · Both sides | $6,025.60 | $9,120.11 | $22,387.21 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 50 · Both sides | $1,445.44 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $117.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $676.08 Typical High $724.44 | Professional | 62 · Two surgeons | $602.56 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,148.15 Median $1,318.26 Typical High $1,412.54 | Professional | 63 · Small infant | $1,148.15 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 80 · Assistant surgeon | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | AS · PA/NP assist | $131.83 | $147.91 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $389.05 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $154.88 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $575.44 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $114.82 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $77.62 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $537.03 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 22 · Increased work | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 50 · Both sides | $1,621.81 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 62 · Two surgeons | $676.08 | $676.08 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 63 · Small infant | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Idaho sits
The same service costs 6.0 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 $11,096MT $1,846
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.