How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,148 to $14,125Professionalmedian $1,023 · 10th to 90th $708 to $1,445
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,445.44 Typical High $1,445.44 | Professional | None | $660.69 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $14,791.08 | Facility | None | $2,511.89 | $3,981.07 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,288.25 | Professional | None | $977.24 | $1,174.90 | $1,288.25 |
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 $812.83 Median $933.25 Typical High $1,096.48 | Professional | None | $812.83 | $933.25 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $5,495.41 | Facility | None | $707.95 | $1,445.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,445.44 | Professional | None | $812.83 | $1,148.15 | $1,445.44 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,148.15 | $1,949.84 |
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 $977.24 Typical High $1,230.27 | Professional | None | $977.24 | $977.24 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $6,606.93 | Facility | None | $537.03 | $549.54 | $6,606.93 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $812.83 | Professional | None | $537.03 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,348.96 | Professional | None | $630.96 | $954.99 | $1,348.96 |
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 $398.11 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $398.11 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $162.18 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $602.56 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $120.23 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $81.28 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $562.34 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $128.82 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $794.33 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,445.44 Typical High $1,513.56 | Professional | 63 · Small infant | $1,230.27 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $204.17 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $194.98 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $162.18 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $194.98 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $173.78 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $407.38 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $165.96 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $616.60 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $123.03 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $81.28 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $575.44 | $1,023.29 | $1,023.29 |
Where Idaho sits
The same service costs 5.1 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 $10,170MT $2,000
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.