How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,995 to $20,417Professionalmedian $1,995 · 10th to 90th $1,380 to $2,455
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 $4,466.84 Median $4,677.35 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,677.35 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,174.90 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $5,754.40 Typical High $23,988.33 | Facility | None | $4,073.80 | $5,754.40 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,290.87 | Professional | None | $1,819.70 | $2,137.96 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $9,549.93 Median $10,715.19 Typical High $14,454.40 | Facility | None | $9,549.93 | $10,715.19 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,548.82 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $4,677.35 | Facility | None | $954.99 | $2,290.87 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,445.44 | $2,290.87 | $2,691.53 |
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 $1,621.81 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,995.26 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,995.26 | $1,995.26 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,791.08 Median $19,498.45 Typical High $24,547.09 | Facility | None | $14,791.08 | $19,498.45 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,290.87 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Facility | None | $954.99 | $954.99 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $9,772.37 | Professional | None | $954.99 | $1,122.02 | $9,772.37 |
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 $1,202.26 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,621.81 | $2,398.83 |
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 $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $724.44 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $288.40 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,071.52 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $213.80 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $144.54 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,466.84 Median $9,549.93 Typical High $35,481.34 | Facility | 50 · Both sides | $4,466.84 | $9,549.93 | $35,481.34 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,090.30 Typical High $3,311.31 | Professional | 50 · Both sides | $2,754.23 | $3,090.30 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,862.09 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $223.87 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,288.25 Typical High $1,380.38 | Professional | 62 · Two surgeons | $1,148.15 | $1,288.25 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,187.76 Median $2,454.71 Typical High $2,691.53 | Professional | 63 · Small infant | $2,187.76 | $2,454.71 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,445.44 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,445.44 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | 80 · Assistant surgeon | $295.12 | $323.59 | $354.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $295.12 | $323.59 | $354.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $323.59 | $354.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $275.42 Typical High $302.00 | Professional | AS · PA/NP assist | $251.19 | $275.42 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $724.44 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $288.40 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,071.52 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $213.80 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $144.54 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,621.81 | $1,621.81 |
Where Idaho sits
The same service costs 10.4 times more in Alaska than in Kentucky. 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 $29,118KY $2,808
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.