How much rates vary
Facilitymedian $178 · 10th to 90th $63 to $550Professionalmedian $107 · 10th to 90th $72 to $178
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 $60.26 Median $100.00 Typical High $158.49 | Professional | None | $60.26 | $100.00 | $158.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $269.15 Typical High $549.54 | Facility | None | $66.07 | $269.15 | $549.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $194.98 | Professional | None | $87.10 | $141.25 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $85.11 | Facility | None | $56.23 | $63.10 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $141.25 | Professional | None | $81.28 | $102.33 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $4,466.84 | Facility | None | $66.07 | $104.71 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $177.83 | Professional | None | $66.07 | $109.65 | $177.83 |
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 $95.50 Median $95.50 Typical High $177.83 | Facility | None | $95.50 | $95.50 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $190.55 | Professional | None | $95.50 | $173.78 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $645.65 | Facility | None | $331.13 | $467.74 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $151.36 | Professional | None | $87.10 | $114.82 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $549.54 | Facility | None | $85.11 | $87.10 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $114.82 | Professional | None | $60.26 | $85.11 | $114.82 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $162.18 | Professional | None | $64.57 | $102.33 | $162.18 |
18 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 $33.11 Median $50.12 Typical High $79.43 | Professional | 52 · Reduced service | $33.11 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.95 Typical High $31.62 | Professional | 53 · Discontinued | $13.18 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $75.86 Typical High $117.49 | Professional | 54 · Surgery only | $50.12 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.14 Typical High $23.44 | Professional | 55 · Aftercare only | $10.00 | $15.14 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $15.85 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $173.78 | Professional | 54 · Surgery only | $79.43 | $97.72 | $173.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.72 Typical High $19.50 | Professional | 55 · Aftercare only | $8.91 | $10.72 | $19.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $107.15 Median $165.96 Typical High $239.88 | Professional | 63 · Small infant | $107.15 | $165.96 | $239.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $89.13 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $61.66 | $89.13 | $141.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $16.60 Typical High $27.54 | Professional | 80 · Assistant surgeon | $14.13 | $16.60 | $27.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.13 Median $17.38 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $14.13 | $17.38 | $32.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $16.60 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $16.60 | $29.51 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $14.79 Typical High $26.30 | Professional | AS · PA/NP assist | $12.02 | $14.79 | $26.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $50.12 Typical High $79.43 | Professional | 52 · Reduced service | $33.11 | $50.12 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.95 Typical High $31.62 | Professional | 53 · Discontinued | $13.18 | $19.95 | $31.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $75.86 Typical High $117.49 | Professional | 54 · Surgery only | $50.12 | $75.86 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.14 Typical High $23.44 | Professional | 55 · Aftercare only | $10.00 | $15.14 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $15.85 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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.
Idaho· 20th of 51
$110
WI $240DC $77.62
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.