How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,622 to $20,893Professionalmedian $1,445 · 10th to 90th $1,023 to $2,089
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 $2,089.30 Median $4,466.84 Typical High $8,511.38 | Facility | None | $2,089.30 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,089.30 | Professional | None | $912.01 | $1,288.25 | $2,089.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,818.38 Median $9,772.37 Typical High $26,915.35 | Facility | None | $2,818.38 | $9,772.37 | $26,915.35 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,659.59 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,318.26 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,951.21 Typical High $20,892.96 | Facility | None | $1,047.13 | $2,951.21 | $20,892.96 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,659.59 | $2,089.30 |
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 $1,318.26 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,318.26 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,621.81 | $2,754.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $19,498.45 Typical High $33,884.42 | Facility | None | $9,772.37 | $19,498.45 | $33,884.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,380.38 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $10,964.78 | Facility | None | $758.58 | $776.25 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,174.90 | Professional | None | $758.58 | $758.58 | $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 $933.25 Median $1,348.96 Typical High $1,949.84 | Professional | None | $933.25 | $1,348.96 | $1,949.84 |
23 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 $575.44 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $575.44 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $229.09 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $870.96 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $173.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $114.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $812.83 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,168.69 Median $14,791.08 Typical High $46,773.51 | Facility | 50 · Both sides | $4,168.69 | $14,791.08 | $46,773.51 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,630.27 Typical High $3,090.30 | Professional | 50 · Both sides | $2,187.76 | $2,630.27 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,548.82 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,288.25 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $181.97 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,737.80 Median $2,041.74 Typical High $2,187.76 | Professional | 63 · Small infant | $1,737.80 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,202.26 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,202.26 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $288.40 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $288.40 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $275.42 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $229.09 | $275.42 | $288.40 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $275.42 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $275.42 | $288.40 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $588.84 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $234.42 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $870.96 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $173.78 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $117.49 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $812.83 | $1,445.44 | $1,445.44 |
Where Idaho sits
The same service costs 4.6 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 $13,103MT $2,825
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.