How much rates vary
Facilitymedian $7,943 · 10th to 90th $2,455 to $26,303Professionalmedian $2,455 · 10th to 90th $1,660 to $2,951
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 $1,445.44 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,445.44 | $2,691.53 | $2,691.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $6,918.31 Typical High $30,902.95 | Facility | None | $4,897.79 | $6,918.31 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,691.53 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $14,791.08 Median $16,595.87 Typical High $22,387.21 | Facility | None | $14,791.08 | $16,595.87 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,862.09 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $4,677.35 | Facility | None | $1,174.90 | $2,691.53 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,691.53 | $3,235.94 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,454.71 | $2,454.71 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,054.61 Median $25,118.86 Typical High $31,622.78 | Facility | None | $19,054.61 | $25,118.86 | $31,622.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,570.40 | $2,754.23 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Facility | None | $1,174.90 | $1,174.90 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $15,135.61 | Professional | None | $1,174.90 | $1,348.96 | $15,135.61 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,949.84 | $2,884.03 |
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 $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $851.14 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $338.84 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,288.25 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $257.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,290.87 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,290.87 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,584.89 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,412.54 | $1,584.89 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,019.95 Typical High $3,311.31 | Professional | 63 · Small infant | $2,754.23 | $3,019.95 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 80 · Assistant surgeon | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $346.74 Typical High $371.54 | Professional | AS · PA/NP assist | $309.03 | $346.74 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $851.14 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $338.84 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,288.25 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $257.04 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $169.82 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,905.46 | $1,905.46 |
Where Idaho sits
The same service costs 6.7 times more in Wyoming 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
WY $22,217KY $3,299
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.