How much rates vary
Facilitymedian $1,380 · 10th to 90th $209 to $5,012Professionalmedian $195 · 10th to 90th $126 to $309
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 $229.09 Median $354.81 Typical High $5,495.41 | Facility | None | $229.09 | $354.81 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $295.12 | Professional | None | $107.15 | $194.98 | $295.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,348.96 | $2,454.71 | $5,248.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $323.59 | Professional | None | $144.54 | $229.09 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,659.59 | Facility | None | $1,096.48 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $239.88 | Professional | None | $138.04 | $173.78 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $229.09 Typical High $4,466.84 | Facility | None | $120.23 | $229.09 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $354.81 | Professional | None | $125.89 | $218.78 | $354.81 |
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 $165.96 Median $165.96 Typical High $295.12 | Facility | None | $165.96 | $165.96 | $295.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $316.23 | Professional | None | $165.96 | $288.40 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $6,606.93 | Facility | None | $3,467.37 | $5,011.87 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $257.04 | Professional | None | $144.54 | $190.55 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $4,073.80 | Facility | None | $141.25 | $144.54 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $190.55 | Professional | None | $104.71 | $141.25 | $190.55 |
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 $107.15 Median $177.83 Typical High $295.12 | Professional | None | $107.15 | $177.83 | $295.12 |
18 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 $63.10 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $63.10 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.90 Typical High $58.88 | Professional | 53 · Discontinued | $25.12 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $144.54 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $144.54 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.84 Typical High $44.67 | Professional | 55 · Aftercare only | $19.05 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.50 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.59 | $19.50 | $29.51 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $138.04 | $165.96 | $288.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $32.36 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $32.36 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $316.23 Typical High $389.05 | Professional | 63 · Small infant | $190.55 | $316.23 | $389.05 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $128.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $104.71 | $128.82 | $223.87 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $43.65 Typical High $53.70 | Professional | 80 · Assistant surgeon | $27.54 | $43.65 | $53.70 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $29.51 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $24.55 | $29.51 | $51.29 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $29.51 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $29.51 | $51.29 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $37.15 Typical High $44.67 | Professional | AS · PA/NP assist | $20.89 | $37.15 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $63.10 | $97.72 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.90 Typical High $58.88 | Professional | 53 · Discontinued | $25.12 | $38.90 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $144.54 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $144.54 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.84 Typical High $44.67 | Professional | 55 · Aftercare only | $19.05 | $28.84 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.50 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.59 | $19.50 | $29.51 |
Where Idaho sits
The same service costs 12.7 times more in Colorado than in North Dakota. 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 $4,551ND $359
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.