How much rates vary
Facilitymedian $2,239 · 10th to 90th $347 to $8,511Professionalmedian $245 · 10th to 90th $158 to $347
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 $245.47 Median $4,466.84 Typical High $7,244.36 | Facility | None | $245.47 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $346.74 Typical High $346.74 | Professional | None | $141.25 | $346.74 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $9,772.37 | Facility | None | $1,737.80 | $2,951.21 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $288.40 | Professional | None | $223.87 | $263.03 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,862.09 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $245.47 | Professional | None | $177.83 | $208.93 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $346.74 Typical High $6,456.54 | Facility | None | $173.78 | $346.74 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $346.74 | Professional | None | $190.55 | $251.19 | $346.74 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $245.47 | Facility | None | $199.53 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | None | $245.47 | $245.47 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $12,302.69 | Facility | None | $6,025.60 | $8,511.38 | $12,302.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $295.12 | Professional | None | $239.88 | $288.40 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $117.49 Typical High $6,760.83 | Facility | None | $114.82 | $117.49 | $6,760.83 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $181.97 | Professional | None | $114.82 | $114.82 | $181.97 |
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 $141.25 Median $208.93 Typical High $302.00 | Professional | None | $141.25 | $208.93 | $302.00 |
18 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 $79.43 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $79.43 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $31.62 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $117.49 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $23.44 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $15.85 | $34.67 | $34.67 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $27.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $263.03 Median $309.03 Typical High $323.59 | Professional | 63 · Small infant | $263.03 | $309.03 | $323.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $181.97 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $151.36 | $181.97 | $190.55 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $41.69 Typical High $43.65 | Professional | 80 · Assistant surgeon | $34.67 | $41.69 | $43.65 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $41.69 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $34.67 | $41.69 | $43.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $41.69 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $41.69 | $43.65 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $35.48 Typical High $37.15 | Professional | AS · PA/NP assist | $29.51 | $35.48 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $95.50 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $38.02 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $144.54 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $28.84 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.05 | $34.67 | $34.67 |
Where Idaho sits
The same service costs 14.3 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 $6,102MT $428
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.