How much rates vary
Facilitymedian $2,188 · 10th to 90th $851 to $7,762Professionalmedian $871 · 10th to 90th $589 to $1,047
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $977.24 | Professional | None | $512.86 | $977.24 | $977.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $3,162.28 Typical High $8,511.38 | Facility | None | $1,621.81 | $3,162.28 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $977.24 | Professional | None | $794.33 | $933.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $741.31 | Professional | None | $562.34 | $660.69 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $5,495.41 | Facility | None | $537.03 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,148.15 | Professional | None | $616.60 | $977.24 | $1,148.15 |
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 $691.83 Median $851.14 Typical High $851.14 | Facility | None | $691.83 | $851.14 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | None | $851.14 | $851.14 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,148.15 | Professional | None | $870.96 | $977.24 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $3,890.45 | Facility | None | $407.38 | $416.87 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $1,862.09 | Professional | None | $407.38 | $478.63 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,000.00 | Professional | None | $501.19 | $691.83 | $1,000.00 |
20 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 $309.03 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $123.03 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $457.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $61.66 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $794.33 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $95.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,047.13 Typical High $1,148.15 | Professional | 63 · Small infant | $933.25 | $1,047.13 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $660.69 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 80 · Assistant surgeon | $125.89 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $125.89 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $120.23 Typical High $128.82 | Professional | AS · PA/NP assist | $107.15 | $120.23 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $123.03 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $457.09 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $61.66 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $676.08 |
Where Idaho sits
The same service costs 4.6 times more in Alabama than in Montana. 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
AL $7,006MT $1,517
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.