How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,778 to $16,218Professionalmedian $1,622 · 10th to 90th $1,096 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 $2,187.76 Median $3,388.44 Typical High $8,709.64 | Facility | None | $2,187.76 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,819.70 Typical High $1,819.70 | Professional | None | $933.25 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $6,456.54 Typical High $18,620.87 | Facility | None | $4,168.69 | $6,456.54 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,778.28 | $1,819.70 |
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 $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 $977.24 Median $2,187.76 Typical High $5,495.41 | Facility | None | $977.24 | $2,187.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,819.70 | $2,187.76 |
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 $1,318.26 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,318.26 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,621.81 | $2,041.74 |
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 $1,621.81 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,819.70 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $10,964.78 | Facility | None | $776.25 | $794.33 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $4,168.69 | Professional | None | $776.25 | $912.01 | $4,168.69 |
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 $954.99 Median $1,288.25 Typical High $1,905.46 | Professional | None | $954.99 | $1,288.25 | $1,905.46 |
22 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 $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $562.34 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $223.87 | $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 $169.82 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $169.82 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $112.20 | $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 $5,128.61 Median $9,549.93 Typical High $28,183.83 | Facility | 50 · Both sides | $5,128.61 | $9,549.93 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,511.89 Typical High $2,754.23 | Professional | 50 · Both sides | $2,238.72 | $2,511.89 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $181.97 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,778.28 Median $1,995.26 Typical High $2,187.76 | Professional | 63 · Small infant | $1,778.28 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $269.15 Typical High $288.40 | Professional | 80 · Assistant surgeon | $239.88 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $269.15 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $239.88 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $269.15 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $562.34 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $223.87 | $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 $169.82 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $169.82 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $112.20 | $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 5.0 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 $14,413MT $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.