How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,380 to $9,120Professionalmedian $1,349 · 10th to 90th $776 to $1,738
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 $724.44 Median $1,737.80 Typical High $1,737.80 | Professional | None | $724.44 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $10,000.00 | Facility | None | $1,905.46 | $3,090.30 | $10,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,548.82 | $1,995.26 |
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 $588.84 Median $1,122.02 Typical High $1,258.93 | Professional | None | $588.84 | $1,122.02 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,737.80 Typical High $5,495.41 | Facility | None | $776.25 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,737.80 | Professional | None | $831.76 | $1,348.96 | $1,737.80 |
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 $1,380.38 Median $1,380.38 Typical High $3,090.30 | Facility | None | $1,380.38 | $1,380.38 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,380.38 | $1,995.26 |
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 $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,621.81 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $5,011.87 | Facility | None | $660.69 | $676.08 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $3,090.30 | Professional | None | $660.69 | $1,023.29 | $3,090.30 |
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 $794.33 Median $1,096.48 Typical High $1,513.56 | Professional | None | $794.33 | $1,096.48 | $1,513.56 |
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 $602.56 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $602.56 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $245.47 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $851.14 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $4,677.35 Typical High $15,135.61 | Facility | 50 · Both sides | $2,754.23 | $4,677.35 | $15,135.61 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,238.72 Typical High $3,019.95 | Professional | 50 · Both sides | $1,905.46 | $2,238.72 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $199.53 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $199.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,258.93 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,479.11 Median $1,778.28 Typical High $2,398.83 | Professional | 63 · Small infant | $1,479.11 | $1,778.28 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,023.29 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $870.96 | $1,023.29 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $323.59 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $234.42 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $199.53 | $234.42 | $323.59 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $234.42 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $234.42 | $323.59 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $275.42 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $616.60 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $245.47 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $123.03 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 3.6 times more in Vermont 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
VT $8,561MT $2,405
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.