How much rates vary
Facilitymedian $3,715 · 10th to 90th $617 to $14,791Professionalmedian $457 · 10th to 90th $288 to $617
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $616.60 | Professional | None | $269.15 | $616.60 | $616.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,511.89 Median $8,511.38 Typical High $17,378.01 | Facility | None | $2,511.89 | $8,511.38 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $512.86 | Professional | None | $416.87 | $489.78 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $436.52 | Professional | None | $316.23 | $371.54 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $616.60 Typical High $5,495.41 | Facility | None | $218.78 | $616.60 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $616.60 | Professional | None | $338.84 | $478.63 | $616.60 |
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 $371.54 Median $457.09 Typical High $457.09 | Facility | None | $371.54 | $457.09 | $457.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $537.03 | Professional | None | $457.09 | $457.09 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $512.86 | Professional | None | $436.52 | $501.19 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Facility | None | $218.78 | $218.78 | $234.42 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | None | $218.78 | $218.78 | $316.23 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
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 $141.25 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $141.25 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $57.54 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $213.80 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $42.66 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $28.84 | $61.66 | $61.66 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $416.87 | $457.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $51.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $549.54 Typical High $616.60 | Professional | 63 · Small infant | $489.78 | $549.54 | $616.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $354.81 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 80 · Assistant surgeon | $66.07 | $74.13 | $81.28 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $66.07 | $74.13 | $81.28 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $74.13 | $81.28 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $63.10 Typical High $69.18 | Professional | AS · PA/NP assist | $56.23 | $63.10 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $169.82 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $67.61 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $251.19 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $51.29 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $33.88 | $61.66 | $61.66 |
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 $10,613MT $815
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.