How much rates vary
Facilitymedian $1,023 · 10th to 90th $219 to $4,169Professionalmedian $871 · 10th to 90th $562 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 $1,023.29 Median $1,148.15 Typical High $5,495.41 | Facility | None | $1,023.29 | $1,148.15 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $954.99 | Professional | None | $562.34 | $870.96 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $208.93 Median $1,174.90 Typical High $4,168.69 | Facility | None | $208.93 | $1,174.90 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,096.48 | Professional | None | $741.31 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $724.44 | Professional | None | $512.86 | $645.65 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $1,023.29 Typical High $6,918.31 | Facility | None | $478.63 | $1,023.29 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,047.13 | Professional | None | $616.60 | $870.96 | $1,047.13 |
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 $812.83 Median $812.83 Typical High $1,000.00 | Facility | None | $812.83 | $812.83 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,258.93 | Professional | None | $812.83 | $1,000.00 | $1,258.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,122.02 | Professional | None | $831.76 | $977.24 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $478.63 Typical High $489.78 | Facility | None | $281.84 | $478.63 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $977.24 | Professional | None | $436.52 | $478.63 | $977.24 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $912.01 | Professional | None | $446.68 | $616.60 | $912.01 |
26 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 $275.42 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $275.42 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $112.20 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $416.87 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $83.18 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $56.23 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $389.05 | $602.56 | $660.69 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $302.00 Median $1,778.28 Typical High $6,309.57 | Facility | 50 · Both sides | $302.00 | $1,778.28 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $1,621.81 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $676.08 | $794.33 | $977.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $97.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $891.25 Median $1,096.48 Typical High $1,318.26 | Professional | 63 · Small infant | $891.25 | $1,096.48 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $776.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $169.82 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $169.82 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $144.54 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $120.23 | $144.54 | $173.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $141.25 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $141.25 | $169.82 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $275.42 | $436.52 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $112.20 | $173.78 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $416.87 | $645.65 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $83.18 | $128.82 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $56.23 | $87.10 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $389.05 | $602.56 | $660.69 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | 50 · Both sides | $1,445.44 | $1,445.44 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $676.08 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $794.33 |
Where Idaho sits
The same service costs 5.3 times more in Colorado than in Florida. 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 $4,377FL $831
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.