How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,042 to $10,965Professionalmedian $2,042 · 10th to 90th $1,445 to $2,570
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 $1,202.26 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,202.26 | $2,344.23 | $2,344.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,265.80 Median $6,606.93 Typical High $12,022.64 | Facility | None | $4,265.80 | $6,606.93 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,238.72 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $8,128.31 | Facility | None | $5,248.07 | $5,888.44 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,621.81 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $5,495.41 | Facility | None | $1,258.93 | $2,344.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,344.23 | $2,818.38 |
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 $1,659.59 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,659.59 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,344.23 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Facility | None | $977.24 | $977.24 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $5,495.41 | Professional | None | $977.24 | $1,174.90 | $5,495.41 |
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 $1,258.93 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,698.24 | $2,511.89 |
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 $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $741.31 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $295.12 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,122.02 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $223.87 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,659.59 | $1,659.59 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,309.57 Median $10,232.93 Typical High $18,197.01 | Facility | 50 · Both sides | $6,309.57 | $10,232.93 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,162.28 Typical High $3,388.44 | Professional | 50 · Both sides | $2,818.38 | $3,162.28 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,905.46 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,318.26 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,174.90 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,238.72 Median $2,511.89 Typical High $2,754.23 | Professional | 63 · Small infant | $2,238.72 | $2,511.89 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | AS · PA/NP assist | $257.04 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $741.31 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $295.12 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,122.02 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $223.87 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $147.91 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,659.59 | $1,659.59 |
Where Idaho sits
The same service costs 5.5 times more in Alaska than in Texas. 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 $14,559TX $2,668
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.