How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,230 to $16,218Professionalmedian $1,072 · 10th to 90th $676 to $1,259
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 $1,318.26 Median $2,884.03 Typical High $7,762.47 | Facility | None | $1,318.26 | $2,884.03 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,096.48 | Professional | None | $588.84 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,890.45 Median $5,623.41 Typical High $18,620.87 | Facility | None | $3,890.45 | $5,623.41 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | None | $912.01 | $1,071.52 | $1,122.02 |
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 $645.65 Median $758.58 Typical High $851.14 | Professional | None | $645.65 | $758.58 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $5,495.41 | Facility | None | $602.56 | $1,318.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,318.26 | Professional | None | $707.95 | $1,096.48 | $1,318.26 |
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 $812.83 Median $1,122.02 Typical High $1,122.02 | Facility | None | $812.83 | $1,122.02 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
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 $1,000.00 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,096.48 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $478.63 Typical High $9,772.37 | Facility | None | $467.74 | $478.63 | $9,772.37 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $4,168.69 | Professional | None | $467.74 | $549.54 | $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 $575.44 Median $776.25 Typical High $1,148.15 | Professional | None | $575.44 | $776.25 | $1,148.15 |
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 $354.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $354.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,370.32 Median $7,762.47 Typical High $28,183.83 | Facility | 50 · Both sides | $5,370.32 | $7,762.47 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,584.89 Typical High $1,659.59 | Professional | 50 · Both sides | $1,380.38 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,096.48 Median $1,258.93 Typical High $1,348.96 | Professional | 63 · Small infant | $1,096.48 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $776.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $169.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $147.91 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $169.82 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $147.91 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $169.82 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $144.54 Typical High $151.36 | Professional | AS · PA/NP assist | $125.89 | $144.54 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $354.81 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $141.25 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
Where Idaho sits
The same service costs 7.9 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 $13,941MT $1,762
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.