How much rates vary
Facilitymedian $1,230 · 10th to 90th $437 to $5,012Professionalmedian $316 · 10th to 90th $245 to $380
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $346.74 | Professional | None | $199.53 | $346.74 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,230.27 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,230.27 | $2,818.38 | $5,128.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $389.05 | Professional | None | $309.03 | $346.74 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,445.44 | Facility | None | $933.25 | $1,047.13 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $346.74 | Professional | None | $251.19 | $302.00 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $5,495.41 | Facility | None | $257.04 | $346.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $380.19 | Professional | None | $257.04 | $346.74 | $380.19 |
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 $269.15 Median $309.03 Typical High $309.03 | Facility | None | $269.15 | $309.03 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | None | $309.03 | $309.03 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,890.45 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | None | $309.03 | $309.03 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $8,511.38 | Facility | None | $158.49 | $162.18 | $8,511.38 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $251.19 | Professional | None | $158.49 | $158.49 | $251.19 |
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 $218.78 Median $316.23 Typical High $436.52 | Professional | None | $218.78 | $316.23 | $436.52 |
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 $100.00 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $100.00 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $39.81 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $151.36 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $30.20 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.95 | $34.67 | $34.67 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $316.23 | $346.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $35.48 | $38.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $354.81 Median $426.58 Typical High $467.74 | Professional | 63 · Small infant | $354.81 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $56.23 Typical High $61.66 | Professional | 80 · Assistant surgeon | $47.86 | $56.23 | $61.66 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $56.23 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $47.86 | $56.23 | $61.66 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $56.23 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $56.23 | $61.66 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $47.86 Typical High $52.48 | Professional | AS · PA/NP assist | $40.74 | $47.86 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $128.82 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $34.67 |
Where Idaho sits
The same service costs 7.6 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 $4,681MT $618
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.