How much rates vary
Facilitymedian $3,388 · 10th to 90th $759 to $11,749Professionalmedian $661 · 10th to 90th $457 to $955
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 $446.68 Median $794.33 Typical High $977.24 | Professional | None | $446.68 | $794.33 | $977.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $13,489.63 | Facility | None | $2,041.74 | $3,630.78 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $954.99 | Professional | None | $537.03 | $660.69 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $4,570.88 | Facility | None | $3,019.95 | $3,388.44 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $676.08 | Professional | None | $478.63 | $562.34 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $5,495.41 | Facility | None | $416.87 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $977.24 | Professional | None | $501.19 | $776.25 | $977.24 |
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 $602.56 Median $602.56 Typical High $870.96 | Facility | None | $602.56 | $602.56 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $954.99 | Professional | None | $602.56 | $870.96 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,982.44 | Facility | None | $8,511.38 | $12,302.69 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $724.44 | Professional | None | $537.03 | $660.69 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $426.58 Typical High $6,760.83 | Facility | None | $416.87 | $426.58 | $6,760.83 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $549.54 | Professional | None | $380.19 | $416.87 | $549.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $831.76 | Professional | None | $389.05 | $549.54 | $831.76 |
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 $223.87 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $223.87 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $89.13 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $331.13 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $66.07 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $44.67 | $79.43 | $97.72 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $5,248.07 Typical High $19,952.62 | Facility | 50 · Both sides | $2,951.21 | $5,248.07 | $19,952.62 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,445.44 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $851.14 | Professional | 54 · Surgery only | $501.19 | $616.60 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $93.33 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $891.25 Typical High $1,174.90 | Professional | 63 · Small infant | $676.08 | $891.25 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $660.69 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $109.65 Typical High $151.36 | Professional | 80 · Assistant surgeon | $87.10 | $109.65 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $109.65 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $89.13 | $109.65 | $154.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $107.15 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $107.15 | $154.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $89.13 Typical High $123.03 | Professional | AS · PA/NP assist | $75.86 | $89.13 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $223.87 | $398.11 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $89.13 | $158.49 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $331.13 | $588.84 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $66.07 | $120.23 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $44.67 | $79.43 | $97.72 |
Where Idaho sits
The same service costs 6.3 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 $7,350MT $1,166
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.