How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,047 to $8,128Professionalmedian $933 · 10th to 90th $603 to $1,148
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 $1,071.52 Median $1,202.26 Typical High $8,511.38 | Facility | None | $1,071.52 | $1,202.26 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $1,023.29 Typical High $1,148.15 | Professional | None | $524.81 | $1,023.29 | $1,148.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $8,128.31 | Facility | None | $2,290.87 | $3,235.94 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,174.90 | Professional | None | $912.01 | $1,071.52 | $1,174.90 |
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 $630.96 Median $851.14 Typical High $954.99 | Professional | None | $630.96 | $851.14 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $10,232.93 | Facility | None | $691.83 | $2,089.30 | $10,232.93 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,148.15 | Professional | None | $676.08 | $1,023.29 | $1,148.15 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,047.13 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,244.36 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $4,265.80 | Facility | None | $501.19 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $741.31 | Professional | None | $501.19 | $501.19 | $741.31 |
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 $537.03 Median $741.31 Typical High $1,071.52 | Professional | None | $537.03 | $741.31 | $1,071.52 |
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 $331.13 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $489.78 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $100.00 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $457.09 | $707.95 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $117.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $741.31 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $741.31 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 63 · Small infant | $1,122.02 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $776.25 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $660.69 | $776.25 | $831.76 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $158.49 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $338.84 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $134.90 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $102.33 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $67.61 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $478.63 | $707.95 | $707.95 |
Where Idaho sits
The same service costs 3.6 times more in Oklahoma 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
OK $6,446MT $1,806
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.