How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,514 to $7,762Professionalmedian $1,738 · 10th to 90th $1,148 to $2,042
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 $1,230.27 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,137.96 | $3,467.37 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,862.09 | $1,949.84 |
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 $1,023.29 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,288.25 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $5,495.41 | Facility | None | $1,047.13 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,905.46 | $2,238.72 |
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 $1,412.54 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,412.54 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,737.80 | $1,737.80 | $2,187.76 |
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 $1,584.89 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,862.09 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $851.14 Typical High $6,309.57 | Facility | None | $831.76 | $851.14 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,862.09 | Professional | None | $831.76 | $912.01 | $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 $933.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $933.25 | $1,288.25 | $1,862.09 |
21 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 $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,445.44 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,122.02 Typical High $1,202.26 | Professional | 62 · Two surgeons | $1,000.00 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,905.46 Median $2,137.96 Typical High $2,344.23 | Professional | 63 · Small infant | $1,905.46 | $2,137.96 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 80 · Assistant surgeon | $257.04 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $257.04 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $245.47 Typical High $263.03 | Professional | AS · PA/NP assist | $218.78 | $245.47 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
Where Idaho sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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
AK $8,167HI $2,648
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.