How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,072 to $4,467Professionalmedian $1,349 · 10th to 90th $1,000 to $1,660
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $3,981.07 | Facility | None | $2,951.21 | $3,311.31 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,412.54 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,258.93 | Professional | None | $977.24 | $1,096.48 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $5,495.41 | Facility | None | $1,000.00 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,621.81 | $1,905.46 |
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 $1,071.52 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,071.52 | $1,318.26 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,318.26 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,584.89 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $676.08 | Facility | None | $630.96 | $630.96 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,202.26 | Professional | None | $630.96 | $776.25 | $1,202.26 |
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 $891.25 Median $1,202.26 Typical High $1,819.70 | Professional | None | $891.25 | $1,202.26 | $1,819.70 |
19 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 $501.19 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $501.19 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $199.53 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $741.31 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $147.91 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $100.00 | $162.18 | $162.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,096.48 | $1,258.93 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $147.91 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $870.96 Typical High $912.01 | Professional | 62 · Two surgeons | $758.58 | $870.96 | $912.01 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,659.59 Typical High $1,778.28 | Professional | 63 · Small infant | $1,445.44 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $223.87 Typical High $234.42 | Professional | 80 · Assistant surgeon | $194.98 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $223.87 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $194.98 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $223.87 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $190.55 Typical High $199.53 | Professional | AS · PA/NP assist | $165.96 | $190.55 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $501.19 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $199.53 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $741.31 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $147.91 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $100.00 | $162.18 | $162.18 |
Where Idaho sits
The same service costs 4.6 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 $9,843KY $2,122
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.