How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,820 to $29,512Professionalmedian $1,585 · 10th to 90th $1,072 to $1,995
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 $912.01 Median $1,819.70 Typical High $1,819.70 | Professional | None | $912.01 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,715.35 Median $12,589.25 Typical High $34,673.69 | Facility | None | $3,715.35 | $12,589.25 | $34,673.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,737.80 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $9,772.37 Median $10,964.78 Typical High $14,791.08 | Facility | None | $9,772.37 | $10,964.78 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,230.27 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $4,466.84 Typical High $16,218.10 | Facility | None | $954.99 | $4,466.84 | $16,218.10 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,819.70 | $2,137.96 |
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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $23,988.33 Median $33,884.42 Typical High $42,657.95 | Facility | None | $23,988.33 | $33,884.42 | $42,657.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,819.70 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $9,549.93 | Facility | None | $758.58 | $776.25 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $10,000.00 | Professional | None | $758.58 | $891.25 | $10,000.00 |
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 $933.25 Median $1,288.25 Typical High $1,905.46 | Professional | None | $933.25 | $1,288.25 | $1,905.46 |
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 $575.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $229.09 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $851.14 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $173.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $794.33 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,623.41 Median $18,620.87 Typical High $51,286.14 | Facility | 50 · Both sides | $5,623.41 | $18,620.87 | $51,286.14 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,454.71 Typical High $2,691.53 | Professional | 50 · Both sides | $2,187.76 | $2,454.71 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $177.83 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,023.29 Typical High $1,122.02 | Professional | 62 · Two surgeons | $912.01 | $1,023.29 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,778.28 Median $1,995.26 Typical High $2,137.96 | Professional | 63 · Small infant | $1,778.28 | $1,995.26 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 80 · Assistant surgeon | $234.42 | $263.03 | $288.40 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $234.42 | $263.03 | $288.40 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $263.03 | $288.40 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | AS · PA/NP assist | $199.53 | $223.87 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $229.09 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $851.14 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $173.78 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $114.82 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $794.33 | $1,288.25 | $1,288.25 |
Where Idaho sits
The same service costs 6.8 times more in Alaska 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
AK $19,480MT $2,858
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.