How much rates vary
Facilitymedian $1,413 · 10th to 90th $537 to $4,266Professionalmedian $417 · 10th to 90th $257 to $708
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $691.83 | Professional | None | $234.42 | $380.19 | $691.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $4,168.69 | Facility | None | $1,174.90 | $2,290.87 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $707.95 | Professional | None | $316.23 | $501.19 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $537.03 | Professional | None | $257.04 | $346.74 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $691.83 Typical High $4,466.84 | Facility | None | $257.04 | $691.83 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $691.83 | Professional | None | $288.40 | $446.68 | $691.83 |
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 $338.84 Median $338.84 Typical High $660.69 | Facility | None | $338.84 | $338.84 | $660.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $831.76 | Professional | None | $338.84 | $426.58 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $794.33 | Professional | None | $371.54 | $457.09 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $3,630.78 | Facility | None | $316.23 | $316.23 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $977.24 | Professional | None | $186.21 | $316.23 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $660.69 | Professional | None | $204.17 | $371.54 | $660.69 |
26 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 $117.49 Median $190.55 Typical High $338.84 | Professional | 52 · Reduced service | $117.49 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $75.86 Typical High $138.04 | Professional | 53 · Discontinued | $46.77 | $75.86 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $288.40 Typical High $512.86 | Professional | 54 · Surgery only | $177.83 | $288.40 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $57.54 Typical High $102.33 | Professional | 55 · Aftercare only | $35.48 | $57.54 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $38.02 Typical High $69.18 | Professional | 56 · Pre-op care only | $23.44 | $38.02 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $269.15 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $165.96 | $269.15 | $478.63 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $3,019.95 Typical High $6,760.83 | Facility | 50 · Both sides | $1,778.28 | $3,019.95 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $912.01 Typical High $1,096.48 | Professional | 50 · Both sides | $501.19 | $912.01 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $457.09 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $457.09 | $660.69 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $31.62 | $57.54 | $70.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $380.19 Median $457.09 Typical High $851.14 | Professional | 63 · Small infant | $380.19 | $457.09 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $288.40 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $218.78 | $288.40 | $489.78 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $66.07 Typical High $114.82 | Professional | 80 · Assistant surgeon | $50.12 | $66.07 | $114.82 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $58.88 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $50.12 | $58.88 | $114.82 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $95.50 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $95.50 | $114.82 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $50.12 Typical High $97.72 | Professional | AS · PA/NP assist | $42.66 | $50.12 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $190.55 Typical High $338.84 | Professional | 52 · Reduced service | $117.49 | $190.55 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $75.86 Typical High $138.04 | Professional | 53 · Discontinued | $46.77 | $75.86 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $288.40 Typical High $512.86 | Professional | 54 · Surgery only | $177.83 | $288.40 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $57.54 Typical High $102.33 | Professional | 55 · Aftercare only | $35.48 | $57.54 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $38.02 Typical High $69.18 | Professional | 56 · Pre-op care only | $23.44 | $38.02 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $269.15 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $165.96 | $269.15 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | 50 · Both sides | $616.60 | $616.60 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $512.86 | Professional | 54 · Surgery only | $288.40 | $288.40 | $512.86 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $72.44 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $549.54 |
Where Idaho sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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
OK $5,125ND $804
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.