How much rates vary
Facilitymedian $4,365 · 10th to 90th $759 to $14,454Professionalmedian $851 · 10th to 90th $562 to $1,288
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 $512.86 Median $831.76 Typical High $1,230.27 | Professional | None | $512.86 | $831.76 | $1,230.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,905.46 Median $4,897.79 Typical High $18,620.87 | Facility | None | $1,905.46 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,318.26 | Professional | None | $707.95 | $933.25 | $1,318.26 |
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 $537.03 Median $676.08 Typical High $954.99 | Professional | None | $537.03 | $676.08 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $8,912.51 | Facility | None | $512.86 | $1,230.27 | $8,912.51 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,230.27 | Professional | None | $630.96 | $977.24 | $1,230.27 |
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 $758.58 Median $758.58 Typical High $1,230.27 | Facility | None | $758.58 | $758.58 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,548.82 | Professional | None | $758.58 | $954.99 | $1,548.82 |
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 $831.76 Median $977.24 Typical High $1,445.44 | Professional | None | $831.76 | $977.24 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $588.84 Typical High $5,128.61 | Facility | None | $575.44 | $588.84 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $4,168.69 | Professional | None | $416.87 | $575.44 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,174.90 | Professional | None | $436.52 | $676.08 | $1,174.90 |
28 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 $257.04 Median $416.87 Typical High $616.60 | Professional | 52 · Reduced service | $257.04 | $416.87 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $165.96 Typical High $245.47 | Professional | 53 · Discontinued | $102.33 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $933.25 | Professional | 54 · Surgery only | $380.19 | $616.60 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $123.03 Typical High $186.21 | Professional | 55 · Aftercare only | $75.86 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $83.18 Typical High $123.03 | Professional | 56 · Pre-op care only | $51.29 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $354.81 | $575.44 | $870.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $2,754.23 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $831.76 Typical High $1,174.90 | Professional | 54 · Surgery only | $630.96 | $831.76 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $131.83 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $131.83 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $724.44 Typical High $851.14 | Professional | 62 · Two surgeons | $436.52 | $724.44 | $851.14 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $831.76 Median $1,348.96 Typical High $1,621.81 | Professional | 63 · Small infant | $831.76 | $1,348.96 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $912.01 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $213.80 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $213.80 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $147.91 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $112.20 | $147.91 | $218.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $147.91 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $147.91 | $213.80 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $154.88 Typical High $181.97 | Professional | AS · PA/NP assist | $97.72 | $154.88 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $416.87 Typical High $616.60 | Professional | 52 · Reduced service | $257.04 | $416.87 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $165.96 Typical High $245.47 | Professional | 53 · Discontinued | $102.33 | $165.96 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $933.25 | Professional | 54 · Surgery only | $380.19 | $616.60 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $123.03 Typical High $186.21 | Professional | 55 · Aftercare only | $75.86 | $123.03 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $83.18 Typical High $123.03 | Professional | 56 · Pre-op care only | $51.29 | $83.18 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $354.81 | $575.44 | $870.96 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $2,041.74 | Professional | 50 · Both sides | $1,380.38 | $1,380.38 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $645.65 | $954.99 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $575.44 Typical High $851.14 | Professional | 62 · Two surgeons | $575.44 | $575.44 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $1,023.29 |
Where Idaho sits
The same service costs 6.5 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 $9,949MT $1,532
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.