How much rates vary
Facilitymedian $1,175 · 10th to 90th $631 to $4,074Professionalmedian $1,000 · 10th to 90th $646 to $1,230
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 $1,202.26 Median $1,318.26 Typical High $5,495.41 | Facility | None | $1,202.26 | $1,318.26 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,148.15 | Professional | None | $562.34 | $1,000.00 | $1,148.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $4,168.69 | Facility | None | $1,174.90 | $1,862.09 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,258.93 | Professional | None | $851.14 | $1,023.29 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $851.14 | Professional | None | $602.56 | $758.58 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,122.02 Typical High $3,090.30 | Facility | None | $616.60 | $1,122.02 | $3,090.30 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,258.93 | Professional | None | $707.95 | $1,000.00 | $1,258.93 |
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 $912.01 Median $912.01 Typical High $1,148.15 | Facility | None | $912.01 | $912.01 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,445.44 | Professional | None | $912.01 | $1,148.15 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,318.26 | Professional | None | $954.99 | $1,122.02 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $2,089.30 | Facility | None | $549.54 | $562.34 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $977.24 | Professional | None | $501.19 | $549.54 | $977.24 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,096.48 | Professional | None | $537.03 | $741.31 | $1,096.48 |
26 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 $316.23 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $316.23 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $125.89 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $63.10 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $776.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $2,570.40 Typical High $6,309.57 | Facility | 50 · Both sides | $1,778.28 | $2,570.40 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $1,778.28 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $758.58 | $891.25 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,047.13 Median $1,202.26 Typical High $1,479.11 | Professional | 63 · Small infant | $1,047.13 | $1,202.26 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $162.18 Typical High $181.97 | Professional | 80 · Assistant surgeon | $141.25 | $162.18 | $181.97 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $165.96 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $134.90 | $165.96 | $199.53 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $165.96 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $165.96 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $162.18 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $316.23 | $501.19 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $125.89 | $199.53 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $758.58 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $63.10 | $100.00 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $776.25 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $1,819.70 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $776.25 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $912.01 |
Where Idaho sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.