How much rates vary
Facilitymedian $1,230 · 10th to 90th $550 to $5,623Professionalmedian $2,570 · 10th to 90th $1,585 to $3,388
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $3,388.44 | Professional | None | $1,584.89 | $3,388.44 | $3,388.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,248.07 Median $5,495.41 Typical High $6,606.93 | Facility | None | $5,248.07 | $5,495.41 | $6,606.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,754.23 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,995.26 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,230.27 | $3,388.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,630.27 | $3,388.44 |
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 $2,089.30 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,089.30 | $2,570.40 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,818.38 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,230.27 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,230.27 | $1,737.80 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,412.54 | $2,137.96 | $3,090.30 |
21 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 $812.83 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $812.83 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $323.59 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,202.26 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $239.88 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $162.18 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,290.87 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,089.30 | $2,290.87 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $288.40 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,621.81 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,445.44 | $1,621.81 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,090.30 Typical High $3,467.37 | Professional | 63 · Small infant | $2,754.23 | $3,090.30 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,819.70 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,819.70 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 80 · Assistant surgeon | $371.54 | $407.38 | $457.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $371.54 | $407.38 | $457.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $407.38 | $457.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $346.74 Typical High $389.05 | Professional | AS · PA/NP assist | $309.03 | $346.74 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $933.25 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $380.19 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,412.54 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $281.84 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $190.55 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,318.26 | $2,398.83 | $2,398.83 |
Where Idaho sits
The same service costs 7.8 times more in Colorado than in Washington. 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 $16,544WA $2,120
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.