How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,380 to $16,218Professionalmedian $1,230 · 10th to 90th $813 to $1,479
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 $1,621.81 Median $2,884.03 Typical High $7,762.47 | Facility | None | $1,621.81 | $2,884.03 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,380.38 Typical High $1,380.38 | Professional | None | $707.95 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $18,620.87 | Facility | None | $3,890.45 | $6,309.57 | $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 $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
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 $2,884.03 Typical High $13,489.63 | Facility | None | $870.96 | $2,884.03 | $13,489.63 |
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 $1,000.00 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,202.26 | $1,548.82 |
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 $10,715.19 | Facility | None | $575.44 | $588.84 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $5,248.07 | Professional | None | $575.44 | $676.08 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,412.54 | Professional | None | $707.95 | $954.99 | $1,412.54 |
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 $436.52 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $436.52 | $676.08 | $676.08 |
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 $128.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $204.17 |
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 $5,888.44 Median $9,332.54 Typical High $28,183.83 | Facility | 50 · Both sides | $5,888.44 | $9,332.54 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,905.46 Typical High $2,041.74 | Professional | 50 · Both sides | $1,698.24 | $1,905.46 | $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 $138.04 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $138.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $776.25 Typical High $851.14 | Professional | 62 · Two surgeons | $707.95 | $776.25 | $851.14 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,348.96 Median $1,513.56 Typical High $1,621.81 | Professional | 63 · Small infant | $1,348.96 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $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 $186.21 | Professional | AS · PA/NP assist | $151.36 | $169.82 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $436.52 | $676.08 | $676.08 |
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 $128.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $204.17 |
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 $13,816MT $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.