How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,089 to $17,378Professionalmedian $2,291 · 10th to 90th $1,585 to $2,818
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 $1,348.96 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,348.96 | $2,630.27 | $2,630.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $6,309.57 Typical High $18,620.87 | Facility | None | $3,548.13 | $6,309.57 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,454.71 | $2,570.40 |
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 $1,513.56 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,778.28 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,630.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,630.27 | $3,090.30 |
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 $1,819.70 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,819.70 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,238.72 | $2,818.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,344.23 | $2,570.40 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $10,715.19 | Facility | None | $1,071.52 | $1,096.48 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $4,168.69 | Professional | None | $1,071.52 | $1,288.25 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,862.09 | $2,754.23 |
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 $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $812.83 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $323.59 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,230.27 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $245.47 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $162.18 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,089.30 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,089.30 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $251.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,445.44 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,288.25 | $1,445.44 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $2,818.38 Typical High $3,019.95 | Professional | 63 · Small infant | $2,511.89 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,621.81 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | 80 · Assistant surgeon | $331.13 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $331.13 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | AS · PA/NP assist | $281.84 | $316.23 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $812.83 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $323.59 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,230.27 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $245.47 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $162.18 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,819.70 | $1,819.70 |
Where Idaho sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.