How much rates vary
Facilitymedian $2,344 · 10th to 90th $417 to $7,762Professionalmedian $589 · 10th to 90th $447 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 $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 $467.74 Median $831.76 Typical High $831.76 | Professional | None | $467.74 | $831.76 | $831.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $2,344.23 Typical High $9,120.11 | Facility | None | $524.81 | $2,344.23 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $707.95 | Professional | None | $562.34 | $660.69 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,398.83 | $2,691.53 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $630.96 | Professional | None | $467.74 | $537.03 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $831.76 Typical High $5,495.41 | Facility | None | $436.52 | $831.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $831.76 | Professional | None | $467.74 | $707.95 | $831.76 |
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 $524.81 Median $630.96 Typical High $630.96 | Facility | None | $524.81 | $630.96 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,122.02 | Professional | None | $630.96 | $630.96 | $1,122.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | None | $562.34 | $562.34 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $1,659.59 | Facility | None | $302.00 | $309.03 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $467.74 | Professional | None | $302.00 | $302.00 | $467.74 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $794.33 | Professional | None | $380.19 | $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 $234.42 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $234.42 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $93.33 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $346.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $69.18 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $46.77 | $83.18 | $83.18 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $3,467.37 Typical High $13,489.63 | Facility | 50 · Both sides | $776.25 | $3,467.37 | $13,489.63 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,047.13 Typical High $1,230.27 | Professional | 50 · Both sides | $851.14 | $1,047.13 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $616.60 | $645.65 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $70.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $812.83 Typical High $851.14 | Professional | 63 · Small infant | $691.83 | $812.83 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $109.65 Typical High $114.82 | Professional | 80 · Assistant surgeon | $91.20 | $109.65 | $114.82 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $109.65 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $91.20 | $109.65 | $114.82 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $109.65 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $109.65 | $114.82 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $93.33 Typical High $97.72 | Professional | AS · PA/NP assist | $77.62 | $93.33 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $234.42 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $93.33 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $346.74 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $70.79 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $46.77 | $83.18 | $83.18 |
Where Idaho sits
The same service costs 5.2 times more in Alaska 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
AK $4,868DE $935
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.