How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,288 to $16,218Professionalmedian $1,288 · 10th to 90th $851 to $1,622
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 $1,174.90 Median $1,737.80 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,737.80 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $1,659.59 | Professional | None | $724.44 | $1,445.44 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,370.32 Median $6,918.31 Typical High $18,620.87 | Facility | None | $5,370.32 | $6,918.31 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,380.38 | $1,445.44 |
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 $851.14 Median $977.24 Typical High $1,122.02 | Professional | None | $851.14 | $977.24 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,174.90 | $7,943.28 | $14,454.40 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $1,698.24 | Professional | None | $912.01 | $1,445.44 | $1,698.24 |
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 $1,047.13 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,047.13 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,258.93 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,445.44 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $13,182.57 | Facility | None | $602.56 | $616.60 | $13,182.57 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $5,495.41 | Professional | None | $602.56 | $707.95 | $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 $758.58 Median $1,023.29 Typical High $1,513.56 | Professional | None | $758.58 | $1,023.29 | $1,513.56 |
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 $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $181.97 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $91.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $7,943.28 Median $10,232.93 Typical High $28,183.83 | Facility | 50 · Both sides | $7,943.28 | $10,232.93 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,949.84 Typical High $2,137.96 | Professional | 50 · Both sides | $1,778.28 | $1,949.84 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $141.25 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $812.83 Typical High $891.25 | Professional | 62 · Two surgeons | $741.31 | $812.83 | $891.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,412.54 Median $1,584.89 Typical High $1,698.24 | Professional | 63 · Small infant | $1,412.54 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $186.21 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $181.97 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $138.04 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $91.20 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,023.29 |
Where Idaho sits
The same service costs 6.1 times more in Colorado than in Montana. 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 $13,882MT $2,270
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.