How much rates vary
Facilitymedian $1,202 · 10th to 90th $490 to $4,467Professionalmedian $490 · 10th to 90th $316 to $832
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 $489.78 Median $4,466.84 Typical High $7,244.36 | Facility | None | $489.78 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $831.76 Typical High $831.76 | Professional | None | $288.40 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $245.47 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $48.98 | $125.89 | $125.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $794.33 Median $1,548.82 Typical High $4,897.79 | Facility | None | $794.33 | $1,548.82 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | None | $457.09 | $537.03 | $562.34 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,513.56 | Facility | None | $977.24 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $478.63 | Professional | None | $346.74 | $407.38 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $831.76 Typical High $5,495.41 | Facility | None | $338.84 | $831.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $831.76 | Professional | None | $323.59 | $549.54 | $831.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $288.40 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $57.54 | $125.89 | $125.89 |
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 $398.11 Median $489.78 Typical High $489.78 | Facility | None | $398.11 | $489.78 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | None | $489.78 | $489.78 | $549.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $4,265.80 Typical High $6,165.95 | Facility | None | $2,754.23 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | None | $467.74 | $562.34 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $3,311.31 | Facility | None | $234.42 | $239.88 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $537.03 | Professional | None | $234.42 | $234.42 | $537.03 |
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 $309.03 Median $407.38 Typical High $602.56 | Professional | None | $309.03 | $407.38 | $602.56 |
16 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 $162.18 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $162.18 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $64.57 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $32.36 | $83.18 | $83.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $549.54 Median $630.96 Typical High $660.69 | Professional | 63 · Small infant | $549.54 | $630.96 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $316.23 | $363.08 | $389.05 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $83.18 Typical High $89.13 | Professional | 80 · Assistant surgeon | $72.44 | $83.18 | $89.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $83.18 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $72.44 | $83.18 | $89.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $83.18 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $83.18 | $89.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $70.79 Typical High $74.13 | Professional | AS · PA/NP assist | $61.66 | $70.79 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $190.55 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $77.62 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $38.02 | $83.18 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 22 · Increased work | $602.56 | $602.56 | $602.56 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 63 · Small infant | $602.56 | $602.56 | $602.56 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Where Idaho sits
The same service costs 5.2 times more in Oklahoma 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
OK $4,508MT $873
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.