How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,995 to $13,183Professionalmedian $2,344 · 10th to 90th $1,622 to $3,548
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 $1,659.59 Median $3,548.13 Typical High $4,365.16 | Professional | None | $1,659.59 | $3,548.13 | $4,365.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,162.28 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,570.40 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,905.46 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,174.90 | $3,548.13 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $4,365.16 | Professional | None | $1,737.80 | $2,570.40 | $4,365.16 |
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 $2,041.74 Median $2,041.74 Typical High $2,884.03 | Facility | None | $2,041.74 | $2,041.74 | $2,884.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,398.83 | $2,884.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,454.71 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $10,715.19 | Facility | None | $1,380.38 | $1,380.38 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,380.38 | $1,862.09 |
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 $1,318.26 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,862.09 | $2,951.21 |
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 $831.76 Median $1,778.28 Typical High $2,187.76 | Professional | 52 · Reduced service | $831.76 | $1,778.28 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $707.95 Typical High $870.96 | Professional | 53 · Discontinued | $331.13 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,630.27 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,258.93 | $2,630.27 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $537.03 Typical High $660.69 | Professional | 55 · Aftercare only | $251.19 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $354.81 Typical High $436.52 | Professional | 56 · Pre-op care only | $165.96 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $2,454.71 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,174.90 | $2,454.71 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,344.23 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,698.24 | $2,344.23 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $323.59 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,691.53 Typical High $3,890.45 | Professional | 63 · Small infant | $2,290.87 | $2,691.53 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,621.81 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,621.81 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $380.19 Typical High $512.86 | Professional | 80 · Assistant surgeon | $338.84 | $380.19 | $512.86 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $426.58 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $295.12 | $426.58 | $501.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $380.19 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $380.19 | $512.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $426.58 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $1,778.28 Typical High $2,187.76 | Professional | 52 · Reduced service | $831.76 | $1,778.28 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $707.95 Typical High $870.96 | Professional | 53 · Discontinued | $331.13 | $707.95 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,630.27 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,258.93 | $2,630.27 | $3,235.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $537.03 Typical High $660.69 | Professional | 55 · Aftercare only | $251.19 | $537.03 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $354.81 Typical High $436.52 | Professional | 56 · Pre-op care only | $165.96 | $354.81 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $2,454.71 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,174.90 | $2,454.71 | $3,019.95 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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 $12,311KY $3,892
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.