How much rates vary
Facilitymedian $4,467 · 10th to 90th $871 to $16,218Professionalmedian $871 · 10th to 90th $589 to $1,096
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 $776.25 Median $1,148.15 Typical High $5,888.44 | Facility | None | $776.25 | $1,148.15 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $1,096.48 | Professional | None | $501.19 | $977.24 | $1,096.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,778.28 Median $4,897.79 Typical High $18,620.87 | Facility | None | $1,778.28 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $977.24 | Professional | None | $794.33 | $954.99 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $741.31 | Professional | None | $562.34 | $660.69 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $17,378.01 | Facility | None | $602.56 | $1,621.81 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,148.15 | Professional | None | $602.56 | $977.24 | $1,148.15 |
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 $707.95 Median $870.96 Typical High $870.96 | Facility | None | $707.95 | $870.96 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,096.48 | Professional | None | $870.96 | $870.96 | $1,096.48 |
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 $851.14 Median $954.99 Typical High $1,148.15 | Professional | None | $851.14 | $954.99 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $426.58 Typical High $4,365.16 | Facility | None | $416.87 | $426.58 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $4,168.69 | Professional | None | $416.87 | $478.63 | $4,168.69 |
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 $512.86 Median $691.83 Typical High $1,000.00 | Professional | None | $512.86 | $691.83 | $1,000.00 |
21 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 $302.00 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $302.00 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $120.23 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $446.68 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $60.26 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $416.87 | $676.08 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $97.72 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $562.34 Typical High $602.56 | Professional | 62 · Two surgeons | $501.19 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 63 · Small infant | $954.99 | $1,071.52 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $676.08 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $144.54 Typical High $154.88 | Professional | 80 · Assistant surgeon | $128.82 | $144.54 | $154.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $154.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $154.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $123.03 Typical High $131.83 | Professional | AS · PA/NP assist | $109.65 | $123.03 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $302.00 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $120.23 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $446.68 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $60.26 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $416.87 | $676.08 | $676.08 |
Where Idaho sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.