How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,349 to $16,218Professionalmedian $1,349 · 10th to 90th $912 to $1,698
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 $1,096.48 Median $1,819.70 Typical High $8,709.64 | Facility | None | $1,096.48 | $1,819.70 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $1,737.80 | Professional | None | $758.58 | $1,513.56 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,951.21 Median $4,897.79 Typical High $18,620.87 | Facility | None | $2,951.21 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,445.44 | $1,513.56 |
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 $891.25 Median $1,023.29 Typical High $1,174.90 | Professional | None | $891.25 | $1,023.29 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $10,000.00 | Facility | None | $954.99 | $3,388.44 | $10,000.00 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,778.28 | Professional | None | $954.99 | $1,513.56 | $1,778.28 |
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 $1,096.48 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,096.48 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
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 $1,348.96 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,513.56 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $8,709.64 | Facility | None | $645.65 | $660.69 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $4,168.69 | Professional | None | $645.65 | $758.58 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,584.89 | Professional | None | $794.33 | $1,071.52 | $1,584.89 |
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 $478.63 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $144.54 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $676.08 | $1,071.52 | $1,071.52 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,265.80 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $4,265.80 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,089.30 Typical High $2,290.87 | Professional | 50 · Both sides | $1,862.09 | $2,089.30 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $870.96 Typical High $954.99 | Professional | 62 · Two surgeons | $776.25 | $870.96 | $954.99 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,698.24 Typical High $1,819.70 | Professional | 63 · Small infant | $1,513.56 | $1,698.24 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | 80 · Assistant surgeon | $199.53 | $223.87 | $245.47 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $199.53 | $223.87 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $223.87 | $245.47 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | AS · PA/NP assist | $169.82 | $190.55 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $144.54 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $676.08 | $1,071.52 | $1,071.52 |
Where Idaho sits
The same service costs 5.7 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 $13,613MT $2,377
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.