How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,380 to $14,125Professionalmedian $1,413 · 10th to 90th $1,000 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 $4,466.84 Median $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $1,659.59 | Professional | None | $831.76 | $1,659.59 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,513.56 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | None | $954.99 | $1,122.02 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,659.59 Typical High $5,495.41 | Facility | None | $812.83 | $1,659.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,659.59 | $1,949.84 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,122.02 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,380.38 | $1,778.28 |
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 $1,445.44 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,621.81 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $9,549.93 | Facility | None | $660.69 | $676.08 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $3,388.44 | Professional | None | $660.69 | $812.83 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,698.24 | Professional | None | $851.14 | $1,148.15 | $1,698.24 |
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 $512.86 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $512.86 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $204.17 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $102.33 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $7,585.78 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $7,585.78 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | 50 · Both sides | $1,905.46 | $2,187.76 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,318.26 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $154.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $912.01 Typical High $977.24 | Professional | 62 · Two surgeons | $794.33 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,737.80 Typical High $1,862.09 | Professional | 63 · Small infant | $1,548.82 | $1,737.80 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,023.29 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,023.29 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 80 · Assistant surgeon | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | AS · PA/NP assist | $173.78 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $512.86 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $204.17 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $102.33 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $10,315KY $2,095
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.