How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,023 to $7,762Professionalmedian $1,023 · 10th to 90th $724 to $1,259
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 $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | None | $724.44 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,715.35 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,715.35 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,148.15 | Professional | None | $954.99 | $1,122.02 | $1,148.15 |
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 $660.69 Median $776.25 Typical High $870.96 | Professional | None | $660.69 | $776.25 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $1,148.15 Typical High $5,495.41 | Facility | None | $724.44 | $1,148.15 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,348.96 | Professional | None | $724.44 | $1,148.15 | $1,348.96 |
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 $831.76 Median $1,023.29 Typical High $1,023.29 | Facility | None | $831.76 | $1,023.29 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,023.29 | $1,288.25 |
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 $1,023.29 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,148.15 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $501.19 Typical High $5,248.07 | Facility | None | $489.78 | $501.19 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,862.09 | Professional | None | $489.78 | $562.34 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,202.26 | Professional | None | $602.56 | $812.83 | $1,202.26 |
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 $363.08 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $363.08 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $144.54 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $549.54 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $109.65 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $512.86 | $794.33 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $954.99 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $114.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,148.15 Median $1,258.93 Typical High $1,380.38 | Professional | 63 · Small infant | $1,148.15 | $1,258.93 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 80 · Assistant surgeon | $151.36 | $169.82 | $186.21 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $151.36 | $169.82 | $186.21 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $169.82 | $186.21 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $154.88 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $363.08 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $144.54 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $549.54 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $109.65 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $512.86 | $794.33 | $794.33 |
Where Idaho sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.