How much rates vary
Facilitymedian $14,454 · 10th to 90th $3,715 to $39,811Professionalmedian $4,786 · 10th to 90th $661 to $12,303
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $4,466.84 Typical High $16,982.44 | Professional | None | $524.81 | $4,466.84 | $16,982.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,079.46 Median $16,595.87 Typical High $48,977.88 | Facility | None | $7,079.46 | $16,595.87 | $48,977.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $9,772.37 Typical High $12,302.69 | Professional | None | $794.33 | $9,772.37 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $13,489.63 Median $15,135.61 Typical High $20,892.96 | Facility | None | $13,489.63 | $15,135.61 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $10,232.93 | Professional | None | $676.08 | $1,047.13 | $10,232.93 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $16,982.44 | Facility | None | $630.96 | $4,786.30 | $16,982.44 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $4,466.84 Typical High $16,982.44 | Professional | None | $676.08 | $4,466.84 | $16,982.44 |
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 $870.96 Median $870.96 Typical High $11,481.54 | Facility | None | $870.96 | $870.96 | $11,481.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $10,715.19 Typical High $11,481.54 | Professional | None | $870.96 | $10,715.19 | $11,481.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $30,902.95 Median $44,668.36 Typical High $57,543.99 | Facility | None | $30,902.95 | $44,668.36 | $57,543.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $10,471.29 | Professional | None | $954.99 | $1,071.52 | $10,471.29 |
Select Health Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,495.41 | $5,495.41 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $5,495.41 Typical High $6,309.57 | Professional | None | $549.54 | $5,495.41 | $6,309.57 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $17,378.01 | Facility | None | $2,570.40 | $10,000.00 | $17,378.01 |
United Setting Professional Modifier None Typical Low $562.34 Median $5,248.07 Typical High $12,022.64 | Professional | None | $562.34 | $5,248.07 | $12,022.64 |
15 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 $316.23 Median $776.25 Typical High $8,511.38 | Professional | 52 · Reduced service | $316.23 | $776.25 | $8,511.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $309.03 Typical High $3,388.44 | Professional | 53 · Discontinued | $128.82 | $309.03 | $3,388.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $1,174.90 Typical High $12,882.50 | Professional | 54 · Surgery only | $478.63 | $1,174.90 | $12,882.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $234.42 Typical High $2,570.40 | Professional | 55 · Aftercare only | $95.50 | $234.42 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $154.88 Typical High $1,698.24 | Professional | 56 · Pre-op care only | $63.10 | $154.88 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $933.25 Typical High $11,220.18 | Professional | 54 · Surgery only | $741.31 | $933.25 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $1,230.27 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $6,456.54 Typical High $7,762.47 | Professional | 62 · Two surgeons | $501.19 | $6,456.54 | $7,762.47 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $12,589.25 Typical High $15,488.17 | Professional | 63 · Small infant | $933.25 | $12,589.25 | $15,488.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $724.44 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $562.34 | $724.44 | $8,709.64 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $776.25 Typical High $8,511.38 | Professional | 52 · Reduced service | $338.84 | $776.25 | $8,511.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $309.03 Typical High $3,388.44 | Professional | 53 · Discontinued | $134.90 | $309.03 | $3,388.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $1,174.90 Typical High $12,882.50 | Professional | 54 · Surgery only | $501.19 | $1,174.90 | $12,882.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $234.42 Typical High $2,570.40 | Professional | 55 · Aftercare only | $100.00 | $234.42 | $2,570.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $154.88 Typical High $1,698.24 | Professional | 56 · Pre-op care only | $67.61 | $154.88 | $1,698.24 |
Where Idaho sits
The same service costs 6.1 times more in Alaska than in Vermont. 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
AK $33,081VT $5,424
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.