How much rates vary
Facilitymedian $1,698 · 10th to 90th $575 to $6,607Professionalmedian $1,122 · 10th to 90th $741 to $1,349
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 $616.60 Median $1,230.27 Typical High $1,230.27 | Professional | None | $616.60 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $7,413.10 | Facility | None | $1,174.90 | $2,041.74 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,202.26 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $954.99 | Professional | None | $691.83 | $831.76 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,230.27 Typical High $5,495.41 | Facility | None | $537.03 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,445.44 | Professional | None | $776.25 | $1,230.27 | $1,445.44 |
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 $912.01 Median $1,122.02 Typical High $1,122.02 | Facility | None | $912.01 | $1,122.02 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,230.27 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $3,311.31 | Facility | None | $537.03 | $549.54 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,412.54 | Professional | None | $537.03 | $616.60 | $1,412.54 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,318.26 | Professional | None | $630.96 | $870.96 | $1,318.26 |
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 $389.05 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $389.05 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $77.62 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $870.96 | $870.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,698.24 Median $2,630.27 Typical High $11,220.18 | Facility | 50 · Both sides | $1,698.24 | $2,630.27 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,737.80 Typical High $1,862.09 | Professional | 50 · Both sides | $1,548.82 | $1,737.80 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $125.89 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | 62 · Two surgeons | $645.65 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 63 · Small infant | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 80 · Assistant surgeon | $165.96 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $165.96 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $158.49 Typical High $169.82 | Professional | AS · PA/NP assist | $141.25 | $158.49 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $389.05 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $77.62 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $870.96 | $870.96 |
Where Idaho sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,475DE $1,401
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.