How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,202 to $18,621Professionalmedian $1,230 · 10th to 90th $832 to $1,514
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 $1,380.38 Typical High $1,380.38 | Professional | None | $724.44 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $6,760.83 Typical High $18,620.87 | Facility | None | $3,548.13 | $6,760.83 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,318.26 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $5,248.07 | $5,888.44 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,047.13 | Professional | None | $794.33 | $933.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,949.84 Typical High $22,387.21 | Facility | None | $870.96 | $1,949.84 | $22,387.21 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,621.81 | Professional | None | $870.96 | $1,380.38 | $1,621.81 |
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 $977.24 Median $1,202.26 Typical High $1,202.26 | Facility | None | $977.24 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,202.26 | $1,513.56 |
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 $1,230.27 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,380.38 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $588.84 Typical High $8,709.64 | Facility | None | $575.44 | $588.84 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $5,370.32 | Professional | None | $575.44 | $676.08 | $5,370.32 |
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 $741.31 Median $1,000.00 Typical High $1,445.44 | Professional | None | $741.31 | $1,000.00 | $1,445.44 |
22 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 $436.52 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $436.52 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $173.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $645.65 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $131.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $87.10 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $602.56 | $954.99 | $954.99 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $10,232.93 Typical High $28,183.83 | Facility | 50 · Both sides | $5,128.61 | $10,232.93 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,862.09 Typical High $2,041.74 | Professional | 50 · Both sides | $1,659.59 | $1,862.09 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $134.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,348.96 Median $1,479.11 Typical High $1,621.81 | Professional | 63 · Small infant | $1,348.96 | $1,479.11 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $954.99 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | 80 · Assistant surgeon | $177.83 | $199.53 | $218.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $177.83 | $199.53 | $218.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $199.53 | $218.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $169.82 Typical High $181.97 | Professional | AS · PA/NP assist | $151.36 | $169.82 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $436.52 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $173.78 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $645.65 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $131.83 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $87.10 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $602.56 | $954.99 | $954.99 |
Where Idaho sits
The same service costs 6.4 times more in Colorado 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
CO $13,837MT $2,168
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.