How much rates vary
Facilitymedian $5,370 · 10th to 90th $2,138 to $20,417Professionalmedian $2,188 · 10th to 90th $1,318 to $2,754
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,380.38 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,754.23 Median $5,370.32 Typical High $23,988.33 | Facility | None | $2,754.23 | $5,370.32 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,398.83 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $10,471.29 Median $11,748.98 Typical High $15,848.93 | Facility | None | $10,471.29 | $11,748.98 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,479.11 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,230.27 | $2,187.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,380.38 | $2,187.76 | $2,570.40 |
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 $2,137.96 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,137.96 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,630.27 | $3,311.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,791.08 Median $19,498.45 Typical High $24,547.09 | Facility | None | $14,791.08 | $19,498.45 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,137.96 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,230.27 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $10,715.19 | Professional | None | $1,071.52 | $1,230.27 | $10,715.19 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,548.82 | $2,290.87 |
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 $676.08 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $676.08 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $275.42 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,981.07 Median $7,943.28 Typical High $32,359.37 | Facility | 50 · Both sides | $3,981.07 | $7,943.28 | $32,359.37 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $4,073.80 Typical High $4,365.16 | Professional | 50 · Both sides | $3,019.95 | $4,073.80 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,398.83 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,778.28 | $2,398.83 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $199.53 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,698.24 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,230.27 | $1,698.24 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,398.83 Median $3,235.94 Typical High $3,467.37 | Professional | 63 · Small infant | $2,398.83 | $3,235.94 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,862.09 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $426.58 Typical High $467.74 | Professional | 80 · Assistant surgeon | $316.23 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $426.58 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $316.23 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $426.58 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $363.08 Typical High $398.11 | Professional | AS · PA/NP assist | $269.15 | $363.08 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $676.08 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $275.42 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $138.04 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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
AK $15,585KY $2,601
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.