How much rates vary
Facilitymedian $1,549 · 10th to 90th $166 to $7,244Professionalmedian $166 · 10th to 90th $100 to $347
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 $162.18 Median $363.08 Typical High $5,495.41 | Facility | None | $162.18 | $363.08 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $309.03 | Professional | None | $81.28 | $162.18 | $309.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $8,511.38 | Facility | None | $1,698.24 | $1,862.09 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $269.15 Typical High $371.54 | Professional | None | $114.82 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $275.42 | Professional | None | $109.65 | $194.98 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $1,698.24 Typical High $8,511.38 | Facility | None | $162.18 | $1,698.24 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $354.81 | Professional | None | $100.00 | $169.82 | $354.81 |
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 $114.82 Median $114.82 Typical High $323.59 | Facility | None | $114.82 | $114.82 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $346.74 | Professional | None | $114.82 | $147.91 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $288.40 | Professional | None | $114.82 | $147.91 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $169.82 Typical High $1,479.11 | Facility | None | $165.96 | $169.82 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $223.87 | Professional | None | $77.62 | $165.96 | $223.87 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $302.00 | Professional | None | $85.11 | $169.82 | $302.00 |
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 $48.98 Median $67.61 Typical High $154.88 | Professional | 52 · Reduced service | $48.98 | $67.61 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $27.54 Typical High $61.66 | Professional | 53 · Discontinued | $19.95 | $27.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $102.33 Typical High $229.09 | Professional | 54 · Surgery only | $74.13 | $102.33 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.42 Typical High $46.77 | Professional | 55 · Aftercare only | $14.79 | $20.42 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.49 Typical High $30.90 | Professional | 56 · Pre-op care only | $10.00 | $13.49 | $30.90 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,511.89 Median $2,818.38 Typical High $12,882.50 | Facility | 50 · Both sides | $2,511.89 | $2,818.38 | $12,882.50 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $478.63 Typical High $575.44 | Professional | 50 · Both sides | $173.78 | $478.63 | $575.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $125.89 Typical High $338.84 | Professional | 54 · Surgery only | $102.33 | $125.89 | $338.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $37.15 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $37.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $154.88 Median $380.19 Typical High $446.68 | Professional | 63 · Small infant | $154.88 | $380.19 | $446.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $104.71 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $81.28 | $104.71 | $269.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $23.44 Typical High $60.26 | Professional | 80 · Assistant surgeon | $18.20 | $23.44 | $60.26 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $23.44 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $19.05 | $23.44 | $60.26 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.20 Median $51.29 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $18.20 | $51.29 | $61.66 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $15.49 Median $36.31 Typical High $52.48 | Professional | AS · PA/NP assist | $15.49 | $36.31 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $67.61 Typical High $154.88 | Professional | 52 · Reduced service | $48.98 | $67.61 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $27.54 Typical High $61.66 | Professional | 53 · Discontinued | $19.95 | $27.54 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $102.33 Typical High $229.09 | Professional | 54 · Surgery only | $74.13 | $102.33 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.42 Typical High $46.77 | Professional | 55 · Aftercare only | $14.79 | $20.42 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.49 Typical High $30.90 | Professional | 56 · Pre-op care only | $10.00 | $13.49 | $30.90 |
Where Idaho sits
The same service costs 9.7 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 $4,351MT $447
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.