How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,148 to $14,791Professionalmedian $1,148 · 10th to 90th $692 to $1,820
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 $645.65 Median $1,819.70 Typical High $1,819.70 | Professional | None | $645.65 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,818.38 Median $8,128.31 Typical High $17,378.01 | Facility | None | $2,818.38 | $8,128.31 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,230.27 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,047.13 | Professional | None | $758.58 | $891.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,819.70 Typical High $5,495.41 | Facility | None | $645.65 | $1,819.70 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,819.70 | Professional | None | $758.58 | $1,202.26 | $1,819.70 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,148.15 | $1,230.27 |
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 $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,288.25 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $10,964.78 | Facility | None | $549.54 | $562.34 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,174.90 | Professional | None | $549.54 | $549.54 | $1,174.90 |
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 $691.83 Median $891.25 Typical High $1,380.38 | Professional | None | $691.83 | $891.25 | $1,380.38 |
27 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 $354.81 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $354.81 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $144.54 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $537.03 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $107.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $70.79 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $501.19 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $128.82 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 62 · Two surgeons | $660.69 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,479.11 Typical High $1,548.82 | Professional | 63 · Small infant | $1,258.93 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $912.01 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 80 · Assistant surgeon | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | AS · PA/NP assist | $144.54 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $436.52 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $173.78 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $645.65 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $128.82 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $87.10 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $602.56 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 22 · Increased work | $1,348.96 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 62 · Two surgeons | $776.25 | $776.25 | $776.25 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 63 · Small infant | $1,348.96 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Where Idaho sits
The same service costs 5.4 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 $11,084MT $2,070
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.