How much rates vary
Facilitymedian $2,291 · 10th to 90th $603 to $8,511Professionalmedian $339 · 10th to 90th $234 to $417
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 $218.78 Median $309.03 Typical High $416.87 | Professional | None | $218.78 | $309.03 | $416.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,659.59 Median $3,162.28 Typical High $9,120.11 | Facility | None | $1,659.59 | $3,162.28 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $426.58 | Professional | None | $323.59 | $389.05 | $426.58 |
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 $263.03 Median $302.00 Typical High $363.08 | Professional | None | $263.03 | $302.00 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $416.87 Typical High $5,495.41 | Facility | None | $245.47 | $416.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $416.87 | Professional | None | $281.84 | $389.05 | $416.87 |
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 $309.03 Median $380.19 Typical High $380.19 | Facility | None | $309.03 | $380.19 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Professional | None | $380.19 | $380.19 | $630.96 |
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 $323.59 Median $323.59 Typical High $407.38 | Professional | None | $323.59 | $323.59 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $6,165.95 | Facility | None | $181.97 | $181.97 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $269.15 | Professional | None | $181.97 | $181.97 | $269.15 |
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 $218.78 Median $309.03 Typical High $436.52 | Professional | None | $218.78 | $309.03 | $436.52 |
22 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 $123.03 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $123.03 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $48.98 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $186.21 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $37.15 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $24.55 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $173.78 | $295.12 | $295.12 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,454.71 Median $4,265.80 Typical High $13,489.63 | Facility | 50 · Both sides | $2,454.71 | $4,265.80 | $13,489.63 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $602.56 Typical High $707.95 | Professional | 50 · Both sides | $512.86 | $602.56 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $363.08 | $380.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $42.66 | Professional | 55 · Aftercare only | $33.88 | $39.81 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $407.38 Median $478.63 Typical High $512.86 | Professional | 63 · Small infant | $407.38 | $478.63 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $295.12 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | 80 · Assistant surgeon | $54.95 | $64.57 | $67.61 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $54.95 | $64.57 | $67.61 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $64.57 | $67.61 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $57.54 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $138.04 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $56.23 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $41.69 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $295.12 | $295.12 |
Where Idaho sits
The same service costs 9.6 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 $6,197MT $647
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.