How much rates vary
Facilitymedian $2,239 · 10th to 90th $759 to $8,511Professionalmedian $269 · 10th to 90th $178 to $389
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $389.05 | Professional | None | $173.78 | $389.05 | $389.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,951.21 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $323.59 | Professional | None | $251.19 | $295.12 | $323.59 |
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 $199.53 Median $234.42 Typical High $275.42 | Professional | None | $199.53 | $234.42 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $5,495.41 | Facility | None | $199.53 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $389.05 | Professional | None | $213.80 | $309.03 | $389.05 |
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 $218.78 Median $269.15 Typical High $269.15 | Facility | None | $218.78 | $269.15 | $269.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | None | $269.15 | $269.15 | $309.03 |
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 $269.15 Median $323.59 Typical High $331.13 | Professional | None | $269.15 | $323.59 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $6,025.60 | Facility | None | $128.82 | $131.83 | $6,025.60 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | None | $128.82 | $128.82 | $204.17 |
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 $162.18 Median $234.42 Typical High $338.84 | Professional | None | $162.18 | $234.42 | $338.84 |
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 $89.13 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $89.13 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $35.48 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $131.83 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $26.30 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $17.78 | $38.90 | $38.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $257.04 Typical High $269.15 | Professional | 54 · Surgery only | $218.78 | $257.04 | $269.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $28.84 | $30.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $288.40 Median $346.74 Typical High $363.08 | Professional | 63 · Small infant | $288.40 | $346.74 | $363.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $169.82 | $199.53 | $208.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $45.71 Typical High $47.86 | Professional | 80 · Assistant surgeon | $38.90 | $45.71 | $47.86 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.90 Median $45.71 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $38.90 | $45.71 | $47.86 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.90 Median $45.71 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $38.90 | $45.71 | $47.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $38.90 Typical High $40.74 | Professional | AS · PA/NP assist | $33.11 | $38.90 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $107.15 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $42.66 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.38 | $38.90 | $38.90 |
Where Idaho sits
The same service costs 13.0 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 $6,260MT $480
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.