How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,202 to $9,120Professionalmedian $1,096 · 10th to 90th $759 to $1,349
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,348.96 Typical High $1,348.96 | Professional | None | $707.95 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $10,471.29 | Facility | None | $2,344.23 | $3,162.28 | $10,471.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,258.93 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,148.15 | Professional | None | $851.14 | $977.24 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $5,495.41 | Facility | None | $575.44 | $1,348.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,348.96 | Professional | None | $891.25 | $1,318.26 | $1,348.96 |
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 $977.24 Median $1,202.26 Typical High $1,202.26 | Facility | None | $977.24 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,202.26 | $2,089.30 |
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 $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $602.56 | Facility | None | $575.44 | $575.44 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | None | $575.44 | $575.44 | $870.96 |
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 $741.31 Median $977.24 Typical High $1,380.38 | Professional | None | $741.31 | $977.24 | $1,380.38 |
21 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 $407.38 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $407.38 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $162.18 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $602.56 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $120.23 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $81.28 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $562.34 | $954.99 | $954.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,174.90 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $851.14 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $851.14 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,318.26 Median $1,548.82 Typical High $1,621.81 | Professional | 63 · Small infant | $1,318.26 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $954.99 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $173.78 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $186.21 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $446.68 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $177.83 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $676.08 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $89.13 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $630.96 | $954.99 | $954.99 |
Where Idaho sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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
OK $7,369KY $1,773
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.