How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,072 to $10,233Professionalmedian $1,072 · 10th to 90th $676 to $1,202
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 $588.84 Median $1,122.02 Typical High $1,122.02 | Professional | None | $588.84 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $12,022.64 | Facility | None | $1,949.84 | $4,265.80 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | None | $977.24 | $1,122.02 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $851.14 | Professional | None | $645.65 | $741.31 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $5,495.41 | Facility | None | $645.65 | $1,122.02 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,288.25 | Professional | None | $691.83 | $1,122.02 | $1,288.25 |
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 $870.96 Median $1,071.52 Typical High $1,071.52 | Facility | None | $870.96 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,071.52 | $1,348.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,288.25 | Professional | None | $954.99 | $1,122.02 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Facility | None | $512.86 | $512.86 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $5,248.07 | Professional | None | $512.86 | $549.54 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
21 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 $346.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $346.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $138.04 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $69.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $120.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $691.83 Typical High $758.58 | Professional | 62 · Two surgeons | $616.60 | $691.83 | $758.58 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,318.26 Typical High $1,445.44 | Professional | 63 · Small infant | $1,174.90 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $776.25 | $851.14 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | 80 · Assistant surgeon | $158.49 | $177.83 | $190.55 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $158.49 | $177.83 | $190.55 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $177.83 | $190.55 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $162.18 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $346.74 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $138.04 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $69.18 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
Where Idaho sits
The same service costs 6.5 times more in Alaska 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
AK $12,011MT $1,848
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.