How much rates vary
Facilitymedian $5,623 · 10th to 90th $933 to $16,218Professionalmedian $776 · 10th to 90th $525 to $955
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 $912.01 Median $4,466.84 Typical High $7,244.36 | Facility | None | $912.01 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | None | $549.54 | $870.96 | $870.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $6,165.95 Typical High $18,620.87 | Facility | None | $2,344.23 | $6,165.95 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | None | $707.95 | $831.76 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $8,128.31 | Facility | None | $5,248.07 | $5,888.44 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $660.69 | Professional | None | $489.78 | $588.84 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $7,244.36 | Facility | None | $549.54 | $912.01 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $1,023.29 | Professional | None | $549.54 | $870.96 | $1,023.29 |
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 $776.25 Typical High $776.25 | Facility | None | $630.96 | $776.25 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $977.24 | Professional | None | $776.25 | $776.25 | $977.24 |
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 $758.58 Median $870.96 Typical High $1,023.29 | Professional | None | $758.58 | $870.96 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $7,413.10 | Facility | None | $371.54 | $380.19 | $7,413.10 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $5,495.41 | Professional | None | $371.54 | $426.58 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $891.25 | Professional | None | $446.68 | $602.56 | $891.25 |
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 $275.42 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $275.42 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $109.65 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $54.95 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $380.19 | $602.56 | $602.56 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $87.10 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | 62 · Two surgeons | $446.68 | $501.19 | $537.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $954.99 Typical High $1,047.13 | Professional | 63 · Small infant | $851.14 | $954.99 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 80 · Assistant surgeon | $114.82 | $128.82 | $138.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $114.82 | $128.82 | $138.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $128.82 | $138.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $109.65 Typical High $117.49 | Professional | AS · PA/NP assist | $97.72 | $109.65 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $275.42 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $109.65 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $54.95 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $380.19 | $602.56 | $602.56 |
Where Idaho sits
The same service costs 8.3 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 $11,304MT $1,368
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.