How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,288 to $18,621Professionalmedian $1,318 · 10th to 90th $912 to $1,622
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $1,479.11 | Professional | None | $794.33 | $1,479.11 | $1,479.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $7,079.46 Typical High $18,620.87 | Facility | None | $5,888.44 | $7,079.46 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,412.54 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,456.54 Typical High $8,709.64 | Facility | None | $5,623.41 | $6,456.54 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | None | $870.96 | $1,023.29 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,479.11 Typical High $5,495.41 | Facility | None | $870.96 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,778.28 | Professional | None | $933.25 | $1,479.11 | $1,778.28 |
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 $1,047.13 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,047.13 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
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 $1,348.96 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,479.11 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $18,620.87 | Facility | None | $616.60 | $630.96 | $18,620.87 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $5,888.44 | Professional | None | $616.60 | $741.31 | $5,888.44 |
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 $794.33 Median $1,047.13 Typical High $1,548.82 | Professional | None | $794.33 | $1,047.13 | $1,548.82 |
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 $467.74 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $467.74 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $93.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $8,912.51 Median $10,232.93 Typical High $28,183.83 | Facility | 50 · Both sides | $8,912.51 | $10,232.93 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,995.26 Typical High $2,187.76 | Professional | 50 · Both sides | $1,778.28 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $144.54 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $831.76 Typical High $912.01 | Professional | 62 · Two surgeons | $741.31 | $831.76 | $912.01 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 63 · Small infant | $1,445.44 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 80 · Assistant surgeon | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | AS · PA/NP assist | $162.18 | $181.97 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $467.74 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $93.33 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
Where Idaho sits
The same service costs 6.2 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 $14,513MT $2,350
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.