How much rates vary
Facilitymedian $4,266 · 10th to 90th $372 to $141,254Professionalmedian $372 · 10th to 90th $209 to $468
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 $223.87 Median $436.52 Typical High $436.52 | Professional | None | $223.87 | $436.52 | $436.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,890.45 Median $56,234.13 Typical High $165,958.69 | Facility | None | $3,890.45 | $56,234.13 | $165,958.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $478.63 | Professional | None | $363.08 | $389.05 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $436.52 Typical High $5,495.41 | Facility | None | $190.55 | $436.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $467.74 | Professional | None | $309.03 | $407.38 | $467.74 |
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 $331.13 Median $371.54 Typical High $371.54 | Facility | None | $331.13 | $371.54 | $371.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | None | $371.54 | $371.54 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $61,659.50 Median $120,226.44 Typical High $177,827.94 | Facility | None | $61,659.50 | $120,226.44 | $177,827.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | None | $363.08 | $363.08 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $9,549.93 | Facility | None | $190.55 | $194.98 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $309.03 | Professional | None | $190.55 | $190.55 | $309.03 |
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 $158.49 Median $257.04 Typical High $478.63 | Professional | None | $158.49 | $257.04 | $478.63 |
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 $120.23 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $120.23 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $47.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $177.83 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $36.31 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.99 | $43.65 | $43.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $389.05 | $426.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $47.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $436.52 Median $512.86 Typical High $575.44 | Professional | 63 · Small infant | $436.52 | $512.86 | $575.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $331.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $69.18 Typical High $75.86 | Professional | 80 · Assistant surgeon | $57.54 | $69.18 | $75.86 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $69.18 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $57.54 | $69.18 | $75.86 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $69.18 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $69.18 | $75.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $58.88 Typical High $64.57 | Professional | AS · PA/NP assist | $48.98 | $58.88 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $61.66 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $234.42 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $46.77 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.90 | $43.65 | $43.65 |
Where Idaho sits
The same service costs 88.6 times more in Wyoming 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
WY $59,374MT $670
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.