How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,380 to $9,120Professionalmedian $1,514 · 10th to 90th $933 to $1,995
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,995.26 Typical High $1,995.26 | Professional | None | $891.25 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $10,000.00 | Facility | None | $1,412.54 | $2,398.83 | $10,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,737.80 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $1,445.44 | Professional | None | $724.44 | $1,288.25 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,495.41 | Facility | None | $1,000.00 | $1,995.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,513.56 | $1,995.26 |
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 $1,258.93 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,258.93 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,548.82 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,456.54 Median $9,120.11 Typical High $12,589.25 | Facility | None | $6,456.54 | $9,120.11 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,819.70 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $741.31 Typical High $4,168.69 | Facility | None | $724.44 | $741.31 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,238.72 | Professional | None | $724.44 | $1,174.90 | $2,238.72 |
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 $1,000.00 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,288.25 | $1,819.70 |
23 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 $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $691.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $275.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,047.13 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $977.24 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,089.30 Median $3,467.37 Typical High $15,135.61 | Facility | 50 · Both sides | $2,089.30 | $3,467.37 | $15,135.61 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,511.89 Typical High $3,467.37 | Professional | 50 · Both sides | $2,137.96 | $2,511.89 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $229.09 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $1,412.54 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,949.84 Typical High $2,754.23 | Professional | 63 · Small infant | $1,659.59 | $1,949.84 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,148.15 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $954.99 | $1,148.15 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $263.03 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $218.78 | $263.03 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $263.03 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $263.03 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $309.03 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $707.95 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $281.84 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,071.52 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $213.80 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $141.25 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,380.38 | $1,380.38 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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 $8,254FL $2,626
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.