How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,995 to $10,233Professionalmedian $2,884 · 10th to 90th $2,042 to $3,548
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,659.59 | $3,311.31 | $3,311.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,025.60 Median $7,585.78 Typical High $12,022.64 | Facility | None | $6,025.60 | $7,585.78 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,311.31 | Professional | None | $2,630.27 | $3,090.30 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $6,025.60 Typical High $8,128.31 | Facility | None | $5,370.32 | $6,025.60 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,995.26 | $2,290.87 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,819.70 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,089.30 | $3,311.31 | $3,890.45 |
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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,818.38 | $2,818.38 | $3,630.78 |
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 $2,818.38 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,818.38 | $3,311.31 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Facility | None | $1,348.96 | $1,348.96 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $5,495.41 | Professional | None | $1,348.96 | $1,621.81 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,398.83 | $3,548.13 |
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 $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,047.13 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $416.87 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,548.82 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $316.23 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,344.23 | $2,344.23 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $9,120.11 Median $11,481.54 Typical High $18,197.01 | Facility | 50 · Both sides | $9,120.11 | $11,481.54 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $4,466.84 Typical High $4,786.30 | Professional | 50 · Both sides | $3,981.07 | $4,466.84 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,630.27 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,344.23 | $2,630.27 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,862.09 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,659.59 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,162.28 Median $3,548.13 Typical High $3,801.89 | Professional | 63 · Small infant | $3,162.28 | $3,548.13 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,041.74 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,041.74 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | 80 · Assistant surgeon | $416.87 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $416.87 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $416.87 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | AS · PA/NP assist | $354.81 | $398.11 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,047.13 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $416.87 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,548.82 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $316.23 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $208.93 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,344.23 | $2,344.23 |
Where Idaho sits
The same service costs 4.7 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 $16,761KY $3,604
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.