How much rates vary
Facilitymedian $5,495 · 10th to 90th $2,399 to $20,417Professionalmedian $2,951 · 10th to 90th $1,995 to $3,548
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 $4,677.35 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,677.35 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,041.74 | $3,235.94 | $3,235.94 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $7,244.36 Typical High $23,988.33 | Facility | None | $4,168.69 | $7,244.36 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,754.23 | $3,235.94 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $8,317.64 Typical High $11,481.54 | Facility | None | $7,413.10 | $8,317.64 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,949.84 | $2,187.76 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $3,235.94 Typical High $4,677.35 | Facility | None | $1,412.54 | $3,235.94 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $3,801.89 | Professional | None | $2,041.74 | $3,235.94 | $3,801.89 |
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 $2,398.83 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,398.83 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,951.21 | $2,951.21 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,791.08 Median $19,498.45 Typical High $24,547.09 | Facility | None | $14,791.08 | $19,498.45 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,884.03 | $3,388.44 | $3,801.89 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Facility | None | $1,412.54 | $1,412.54 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $7,762.47 | Professional | None | $1,412.54 | $1,584.89 | $7,762.47 |
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 $1,737.80 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,398.83 | $3,467.37 |
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 $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,023.29 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,513.56 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,238.72 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,754.23 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,454.71 | $2,754.23 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 55 · Aftercare only | $275.42 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $1,905.46 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,737.80 | $1,905.46 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,715.35 Typical High $3,981.07 | Professional | 63 · Small infant | $3,311.31 | $3,715.35 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,137.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,137.96 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 80 · Assistant surgeon | $436.52 | $489.78 | $537.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $436.52 | $489.78 | $537.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $489.78 | $537.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | AS · PA/NP assist | $371.54 | $416.87 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,023.29 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $407.38 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,513.56 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $309.03 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $204.17 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,238.72 | $2,238.72 |
Where Idaho sits
The same service costs 5.3 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 $17,981KY $3,363
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.