How much rates vary
Facilitymedian $1,950 · 10th to 90th $575 to $7,586Professionalmedian $891 · 10th to 90th $562 to $1,479
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $1,479.11 Typical High $1,479.11 | Professional | None | $537.03 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $426.58 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $398.11 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,230.27 Median $2,344.23 Typical High $8,317.64 | Facility | None | $1,230.27 | $2,344.23 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,023.29 | Professional | None | $794.33 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $831.76 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $645.65 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $851.14 | Professional | None | $588.84 | $707.95 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,479.11 Typical High $5,495.41 | Facility | None | $575.44 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,479.11 | Professional | None | $707.95 | $977.24 | $1,479.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $524.81 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $489.78 | $1,047.13 | $1,047.13 |
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 $707.95 Median $870.96 Typical High $870.96 | Facility | None | $707.95 | $870.96 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | None | $870.96 | $870.96 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | None | $870.96 | $1,023.29 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $4,897.79 | Facility | None | $416.87 | $416.87 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $954.99 | Professional | None | $416.87 | $416.87 | $954.99 |
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 $549.54 Median $707.95 Typical High $1,071.52 | Professional | None | $549.54 | $707.95 | $1,071.52 |
17 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 $288.40 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $288.40 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $114.82 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $85.11 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $57.54 | $147.91 | $147.91 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $100.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,096.48 Typical High $1,202.26 | Professional | 63 · Small infant | $954.99 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 80 · Assistant surgeon | $128.82 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $128.82 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $125.89 Typical High $134.90 | Professional | AS · PA/NP assist | $109.65 | $125.89 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $346.74 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $141.25 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $104.71 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $70.79 | $147.91 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 22 · Increased work | $1,096.48 | $1,096.48 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 63 · Small infant | $1,096.48 | $1,096.48 | $1,096.48 |
Where Idaho sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.