How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,399 to $10,965Professionalmedian $2,630 · 10th to 90th $1,862 to $3,311
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $3,019.95 | Professional | None | $1,905.46 | $3,019.95 | $3,019.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $12,022.64 | Facility | None | $5,495.41 | $6,918.31 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,019.95 | Professional | None | $2,398.83 | $2,818.38 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,659.59 | $2,089.30 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $3,019.95 Typical High $5,495.41 | Facility | None | $1,258.93 | $3,019.95 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $3,548.13 | Professional | None | $1,905.46 | $3,019.95 | $3,548.13 |
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 $2,137.96 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,137.96 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,630.27 | $2,630.27 | $3,311.31 |
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 $2,570.40 Median $3,019.95 Typical High $3,548.13 | Professional | None | $2,570.40 | $3,019.95 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,258.93 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $4,168.69 | Professional | None | $1,258.93 | $1,513.56 | $4,168.69 |
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 $1,548.82 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,187.76 | $3,235.94 |
23 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 $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $954.99 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $380.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,445.44 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $288.40 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $8,317.64 Median $11,220.18 Typical High $18,197.01 | Facility | 50 · Both sides | $8,317.64 | $11,220.18 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,630.78 Median $4,073.80 Typical High $4,365.16 | Professional | 50 · Both sides | $3,630.78 | $4,073.80 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,398.83 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,187.76 | $2,398.83 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,698.24 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,513.56 | $1,698.24 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,884.03 Median $3,235.94 Typical High $3,548.13 | Professional | 63 · Small infant | $2,884.03 | $3,235.94 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 80 · Assistant surgeon | $389.05 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $389.05 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $363.08 Typical High $398.11 | Professional | AS · PA/NP assist | $331.13 | $363.08 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $954.99 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $380.19 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,445.44 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $288.40 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $190.55 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,137.96 | $2,137.96 |
Where Idaho sits
The same service costs 5.5 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 $15,938KY $2,890
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.