How much rates vary
Facilitymedian $2,344 · 10th to 90th $933 to $8,913Professionalmedian $708 · 10th to 90th $490 to $871
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 $1,023.29 Median $1,047.13 Typical High $8,709.64 | Facility | None | $1,023.29 | $1,047.13 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $870.96 | Professional | None | $457.09 | $616.60 | $870.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $10,471.29 | Facility | None | $2,344.23 | $4,073.80 | $10,471.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $977.24 | Professional | None | $660.69 | $794.33 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,905.46 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $741.31 | Professional | None | $549.54 | $630.96 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $4,466.84 Typical High $8,317.64 | Facility | None | $575.44 | $4,466.84 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $870.96 | Professional | None | $537.03 | $831.76 | $870.96 |
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 $630.96 Median $776.25 Typical High $776.25 | Facility | None | $630.96 | $776.25 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,318.26 | Professional | None | $776.25 | $776.25 | $1,318.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,165.95 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $7,079.46 | Facility | None | $363.08 | $371.54 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $562.34 | Professional | None | $363.08 | $363.08 | $562.34 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $933.25 | Professional | None | $467.74 | $660.69 | $933.25 |
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 $281.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $281.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $56.23 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $602.56 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $6,025.60 Typical High $15,848.93 | Facility | 50 · Both sides | $3,548.13 | $6,025.60 | $15,848.93 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $1,445.44 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $741.31 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $87.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $831.76 Median $977.24 Typical High $1,047.13 | Professional | 63 · Small infant | $831.76 | $977.24 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $602.56 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $109.65 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $117.49 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $281.84 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $602.56 |
Where Idaho sits
The same service costs 5.5 times more in Wisconsin 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
WI $7,406MT $1,352
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.