How much rates vary
Facilitymedian $5,248 · 10th to 90th $550 to $18,621Professionalmedian $631 · 10th to 90th $437 to $933
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $776.25 Typical High $933.25 | Professional | None | $426.58 | $776.25 | $933.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $6,760.83 Typical High $23,988.33 | Facility | None | $524.81 | $6,760.83 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $912.01 | Professional | None | $512.86 | $645.65 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,495.41 | $6,165.95 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $660.69 | Professional | None | $467.74 | $549.54 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $933.25 Typical High $5,495.41 | Facility | None | $398.11 | $933.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $933.25 | Professional | None | $478.63 | $758.58 | $933.25 |
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 $588.84 Median $588.84 Typical High $831.76 | Facility | None | $588.84 | $588.84 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $933.25 | Professional | None | $588.84 | $831.76 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,848.93 Median $22,908.68 Typical High $30,199.52 | Facility | None | $15,848.93 | $22,908.68 | $30,199.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $691.83 | Professional | None | $512.86 | $630.96 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $3,715.35 | Facility | None | $398.11 | $407.38 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $537.03 | Professional | None | $371.54 | $398.11 | $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 $371.54 Median $537.03 Typical High $794.33 | Professional | None | $371.54 | $537.03 | $794.33 |
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 $213.80 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $213.80 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $85.11 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $323.59 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $64.57 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $42.66 | $77.62 | $93.33 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $10,000.00 Typical High $36,307.81 | Facility | 50 · Both sides | $776.25 | $10,000.00 | $36,307.81 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $575.44 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $933.25 Typical High $1,096.48 | Professional | 63 · Small infant | $645.65 | $933.25 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $645.65 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $120.23 Typical High $144.54 | Professional | 80 · Assistant surgeon | $87.10 | $120.23 | $144.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $102.33 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $89.13 | $102.33 | $144.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $123.03 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $123.03 | $144.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $89.13 Typical High $123.03 | Professional | AS · PA/NP assist | $74.13 | $89.13 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $213.80 | $389.05 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $85.11 | $154.88 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $323.59 | $575.44 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $64.57 | $114.82 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $42.66 | $77.62 | $93.33 |
Where Idaho sits
The same service costs 9.3 times more in Wyoming 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
WY $10,585DE $1,135
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.