How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,778 to $14,454Professionalmedian $1,585 · 10th to 90th $1,023 to $1,950
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 $1,862.09 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,862.09 | $2,137.96 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,778.28 Typical High $1,778.28 | Professional | None | $891.25 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,801.89 Median $6,760.83 Typical High $18,620.87 | Facility | None | $3,801.89 | $6,760.83 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,737.80 | $1,778.28 |
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 $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $1,778.28 Median $7,079.46 Typical High $10,000.00 | Facility | None | $1,778.28 | $7,079.46 | $10,000.00 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,778.28 | $2,089.30 |
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 $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 $1,584.89 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,778.28 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $10,715.19 | Facility | None | $758.58 | $776.25 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $5,495.41 | Professional | None | $758.58 | $870.96 | $5,495.41 |
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 $912.01 Median $1,258.93 Typical High $1,819.70 | Professional | None | $912.01 | $1,258.93 | $1,819.70 |
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 $562.34 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $229.09 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $851.14 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,623.41 Median $9,772.37 Typical High $28,183.83 | Facility | 50 · Both sides | $5,623.41 | $9,772.37 | $28,183.83 |
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 $1,949.84 Typical High $2,137.96 | Professional | 63 · Small infant | $1,778.28 | $1,949.84 | $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 $239.88 | Professional | AS · PA/NP assist | $199.53 | $223.87 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $229.09 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $851.14 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,258.93 |
Where Idaho sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.