How much rates vary
Facilitymedian $240 · 10th to 90th $74 to $501Professionalmedian $115 · 10th to 90th $68 to $145
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 $67.61 Median $72.44 Typical High $89.13 | Professional | None | $67.61 | $72.44 | $89.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $165.96 Median $251.19 Typical High $446.68 | Facility | None | $165.96 | $251.19 | $446.68 |
BCBS Idaho Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | None | $125.89 | $138.04 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $72.44 Typical High $5,495.41 | Facility | None | $66.07 | $72.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $128.82 | Professional | None | $67.61 | $72.44 | $128.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $74.13 Median $83.18 Typical High $120.23 | Facility | None | $74.13 | $83.18 | $120.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $141.25 | Professional | None | $74.13 | $83.18 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | None | $100.00 | $125.89 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $67.61 Typical High $338.84 | Facility | None | $66.07 | $67.61 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $151.36 | Professional | None | $66.07 | $83.18 | $151.36 |
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 $93.33 Median $125.89 Typical High $177.83 | Professional | None | $93.33 | $125.89 | $177.83 |
14 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 $33.88 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.80 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $107.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $22.91 Typical High $23.99 | Professional | 80 · Assistant surgeon | $20.42 | $22.91 | $23.99 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $22.91 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $20.42 | $22.91 | $23.99 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $19.50 Typical High $20.42 | Professional | AS · PA/NP assist | $17.38 | $19.50 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.80 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $51.29 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.24 |
Where Idaho sits
The same service costs 16.6 times more in Alabama than in Delaware. 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
AL $3,321DE $200
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.