How much rates vary
Facilitymedian $2,512 · 10th to 90th $813 to $7,244Professionalmedian $692 · 10th to 90th $240 to $1,585
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 $194.98 Median $707.95 Typical High $2,454.71 | Professional | None | $194.98 | $707.95 | $2,454.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $8,317.64 | Facility | None | $1,621.81 | $2,818.38 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $295.12 Median $1,258.93 Typical High $1,659.59 | Professional | None | $295.12 | $1,258.93 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $3,467.37 | Facility | None | $2,238.72 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $1,288.25 | Professional | None | $257.04 | $380.19 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,174.90 Typical High $5,495.41 | Facility | None | $234.42 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $812.83 Typical High $2,454.71 | Professional | None | $245.47 | $812.83 | $2,454.71 |
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 $323.59 Median $323.59 Typical High $1,479.11 | Facility | None | $323.59 | $323.59 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $1,479.11 Typical High $1,548.82 | Professional | None | $323.59 | $1,479.11 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $10,471.29 | Facility | None | $5,495.41 | $7,943.28 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $1,513.56 | Professional | None | $346.74 | $380.19 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $4,570.88 | Facility | None | $691.83 | $707.95 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $691.83 Typical High $933.25 | Professional | None | $204.17 | $691.83 | $933.25 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $199.53 Median $660.69 Typical High $1,445.44 | Professional | None | $199.53 | $660.69 | $1,445.44 |
20 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 $117.49 Median $281.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $117.49 | $281.84 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $112.20 Typical High $489.78 | Professional | 53 · Discontinued | $46.77 | $112.20 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $416.87 Typical High $1,819.70 | Professional | 54 · Surgery only | $177.83 | $416.87 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $83.18 Typical High $371.54 | Professional | 55 · Aftercare only | $35.48 | $83.18 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $56.23 Typical High $245.47 | Professional | 56 · Pre-op care only | $23.44 | $56.23 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $389.05 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $165.96 | $389.05 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,258.93 Typical High $1,479.11 | Professional | 54 · Surgery only | $309.03 | $1,258.93 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $134.90 Typical High $165.96 | Professional | 55 · Aftercare only | $29.51 | $134.90 | $165.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $346.74 Median $436.52 Typical High $1,905.46 | Professional | 63 · Small infant | $346.74 | $436.52 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $263.03 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $208.93 | $263.03 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $218.78 Typical High $257.04 | Professional | 80 · Assistant surgeon | $48.98 | $218.78 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $57.54 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $47.86 | $57.54 | $251.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $60.26 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $60.26 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $204.17 Typical High $223.87 | Professional | AS · PA/NP assist | $41.69 | $204.17 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $281.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $123.03 | $281.84 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $112.20 Typical High $489.78 | Professional | 53 · Discontinued | $48.98 | $112.20 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $416.87 Typical High $1,819.70 | Professional | 54 · Surgery only | $186.21 | $416.87 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $83.18 Typical High $371.54 | Professional | 55 · Aftercare only | $37.15 | $83.18 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $56.23 Typical High $245.47 | Professional | 56 · Pre-op care only | $24.55 | $56.23 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $389.05 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $173.78 | $389.05 | $1,698.24 |
Where Idaho sits
The same service costs 5.1 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 $7,315MT $1,443
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.