How much rates vary
Facilitymedian $7,586 · 10th to 90th $2,455 to $20,417Professionalmedian $2,455 · 10th to 90th $1,660 to $3,090
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 $2,041.74 Median $3,388.44 Typical High $5,495.41 | Facility | None | $2,041.74 | $3,388.44 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,412.54 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,248.07 Median $9,549.93 Typical High $23,988.33 | Facility | None | $5,248.07 | $9,549.93 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,630.27 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $8,317.64 Typical High $11,481.54 | Facility | None | $7,413.10 | $8,317.64 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,949.84 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $3,388.44 Typical High $19,054.61 | Facility | None | $1,513.56 | $3,388.44 | $19,054.61 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,818.38 | $3,311.31 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,454.71 | $2,454.71 | $3,090.30 |
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 $2,511.89 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,511.89 | $2,818.38 | $3,311.31 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $12,022.64 | Facility | None | $1,174.90 | $1,174.90 | $12,022.64 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $7,762.47 | Professional | None | $1,174.90 | $1,412.54 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $12,022.64 | Facility | None | $1,584.89 | $5,495.41 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,041.74 | $3,019.95 |
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 $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $891.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $354.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,348.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $269.15 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $7,943.28 Median $15,135.61 Typical High $32,359.37 | Facility | 50 · Both sides | $7,943.28 | $15,135.61 | $32,359.37 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $3,801.89 Typical High $4,073.80 | Professional | 50 · Both sides | $3,388.44 | $3,801.89 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,290.87 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,290.87 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,584.89 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,412.54 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,019.95 Typical High $3,311.31 | Professional | 63 · Small infant | $2,691.53 | $3,019.95 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 80 · Assistant surgeon | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $338.84 Typical High $371.54 | Professional | AS · PA/NP assist | $309.03 | $338.84 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $891.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $354.81 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,348.96 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $269.15 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $177.83 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 7.5 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 $26,647KY $3,535
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.