How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,818 to $26,303Professionalmedian $3,548 · 10th to 90th $2,512 to $4,365
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 $2,570.40 Median $4,073.80 Typical High $4,073.80 | Professional | None | $2,570.40 | $4,073.80 | $4,073.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $30,902.95 | Facility | None | $7,413.10 | $10,232.93 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $3,981.07 | Professional | None | $3,162.28 | $3,715.35 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $15,135.61 Median $16,982.44 Typical High $23,442.29 | Facility | None | $15,135.61 | $16,982.44 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,818.38 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $4,073.80 Typical High $5,495.41 | Facility | None | $1,621.81 | $4,073.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $4,786.30 | Professional | None | $2,570.40 | $4,073.80 | $4,786.30 |
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 $2,818.38 Median $3,467.37 Typical High $3,467.37 | Facility | None | $2,818.38 | $3,467.37 | $3,467.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,365.16 | Professional | None | $3,467.37 | $3,467.37 | $4,365.16 |
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 $3,630.78 Median $3,981.07 Typical High $4,786.30 | Professional | None | $3,630.78 | $3,981.07 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,737.80 | Facility | None | $1,621.81 | $1,621.81 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $15,848.93 | Professional | None | $1,621.81 | $1,995.26 | $15,848.93 |
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 $2,137.96 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,137.96 | $2,951.21 | $4,365.16 |
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 $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,288.25 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $512.86 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,949.84 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $389.05 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $257.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,235.94 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,884.03 | $3,235.94 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,995.26 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,801.89 Median $4,265.80 Typical High $4,570.88 | Professional | 63 · Small infant | $3,801.89 | $4,265.80 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,511.89 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,511.89 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | 80 · Assistant surgeon | $512.86 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $512.86 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $512.86 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $489.78 Typical High $524.81 | Professional | AS · PA/NP assist | $426.58 | $489.78 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,288.25 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $512.86 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,949.84 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $389.05 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $257.04 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,818.38 | $2,818.38 |
Where Idaho sits
The same service costs 5.4 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 $23,625KY $4,386
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.