How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,905 to $17,378Professionalmedian $1,905 · 10th to 90th $1,318 to $2,344
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 $1,348.96 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,348.96 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $18,620.87 | Facility | None | $3,548.13 | $6,025.60 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,137.96 | Professional | None | $1,778.28 | $2,089.30 | $2,137.96 |
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 $1,174.90 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,445.44 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,122.02 | $2,187.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,348.96 | $2,187.76 | $2,570.40 |
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 $1,548.82 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,548.82 | $1,905.46 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,905.46 | $1,905.46 | $2,398.83 |
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 $1,905.46 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,905.46 | $2,137.96 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $8,709.64 | Facility | None | $912.01 | $933.25 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $4,168.69 | Professional | None | $912.01 | $1,071.52 | $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 $1,047.13 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,479.11 | $2,137.96 |
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 $676.08 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $676.08 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $269.15 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $134.90 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,370.32 Median $8,511.38 Typical High $28,183.83 | Facility | 50 · Both sides | $5,370.32 | $8,511.38 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $2,951.21 Typical High $3,235.94 | Professional | 50 · Both sides | $2,630.27 | $2,951.21 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,778.28 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $213.80 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,230.27 Typical High $1,348.96 | Professional | 62 · Two surgeons | $1,096.48 | $1,230.27 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,137.96 Median $2,398.83 Typical High $2,570.40 | Professional | 63 · Small infant | $2,137.96 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 80 · Assistant surgeon | $281.84 | $316.23 | $346.74 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $281.84 | $316.23 | $346.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $316.23 | $346.74 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | AS · PA/NP assist | $239.88 | $269.15 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $676.08 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $269.15 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $134.90 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 5.1 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 $14,362HI $2,794
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.