How much rates vary
Facilitymedian $2,042 · 10th to 90th $759 to $7,244Professionalmedian $759 · 10th to 90th $490 to $1,122
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,122.02 | Professional | None | $457.09 | $724.44 | $1,122.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $8,511.38 | Facility | None | $1,621.81 | $2,511.89 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,122.02 | Professional | None | $588.84 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $870.96 | Professional | None | $489.78 | $616.60 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $1,023.29 Typical High $5,495.41 | Facility | None | $416.87 | $1,023.29 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,122.02 | Professional | None | $524.81 | $831.76 | $1,122.02 |
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 $630.96 Median $630.96 Typical High $1,023.29 | Facility | None | $630.96 | $630.96 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,288.25 | Professional | None | $630.96 | $794.33 | $1,288.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,288.25 | Professional | None | $691.83 | $831.76 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $501.19 Typical High $3,890.45 | Facility | None | $489.78 | $501.19 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $1,862.09 | Professional | None | $346.74 | $489.78 | $1,862.09 |
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 $436.52 Median $691.83 Typical High $1,230.27 | Professional | None | $436.52 | $691.83 | $1,230.27 |
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 $229.09 Median $363.08 Typical High $562.34 | Professional | 52 · Reduced service | $229.09 | $363.08 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $144.54 Typical High $223.87 | Professional | 53 · Discontinued | $91.20 | $144.54 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $537.03 Typical High $851.14 | Professional | 54 · Surgery only | $338.84 | $537.03 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $109.65 Typical High $169.82 | Professional | 55 · Aftercare only | $69.18 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $72.44 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $794.33 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,548.13 Typical High $12,589.25 | Facility | 50 · Both sides | $2,344.23 | $3,548.13 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,174.90 Typical High $1,698.24 | Professional | 50 · Both sides | $891.25 | $1,174.90 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $851.14 Typical High $1,047.13 | Professional | 54 · Surgery only | $602.56 | $851.14 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $107.15 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $107.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $851.14 Typical High $1,380.38 | Professional | 63 · Small infant | $691.83 | $851.14 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $794.33 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $123.03 Typical High $186.21 | Professional | 80 · Assistant surgeon | $93.33 | $123.03 | $186.21 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $112.20 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $93.33 | $112.20 | $177.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $109.65 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $109.65 | $177.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $95.50 Typical High $151.36 | Professional | AS · PA/NP assist | $79.43 | $95.50 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $363.08 Typical High $562.34 | Professional | 52 · Reduced service | $229.09 | $363.08 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $144.54 Typical High $223.87 | Professional | 53 · Discontinued | $91.20 | $144.54 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $537.03 Typical High $851.14 | Professional | 54 · Surgery only | $338.84 | $537.03 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $109.65 Typical High $169.82 | Professional | 55 · Aftercare only | $69.18 | $109.65 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $72.44 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $72.44 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,148.15 Typical High $1,737.80 | Professional | 50 · Both sides | $1,148.15 | $1,148.15 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $812.83 | Professional | 54 · Surgery only | $537.03 | $537.03 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $870.96 |
Where Idaho sits
The same service costs 4.4 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 $6,451MT $1,460
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.