How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,288 to $12,303Professionalmedian $1,175 · 10th to 90th $776 to $1,479
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 $1,122.02 Median $1,548.82 Typical High $8,511.38 | Facility | None | $1,122.02 | $1,548.82 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,479.11 | Professional | None | $741.31 | $1,047.13 | $1,479.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $5,754.40 Typical High $12,882.50 | Facility | None | $4,073.80 | $5,754.40 | $12,882.50 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,318.26 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $5,011.87 | Facility | None | $3,235.94 | $3,630.78 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,258.93 | Professional | None | $912.01 | $1,071.52 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $15,848.93 | Facility | None | $1,096.48 | $7,413.10 | $15,848.93 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $1,548.82 | Professional | None | $794.33 | $1,288.25 | $1,548.82 |
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 $1,288.25 Median $1,288.25 Typical High $5,754.40 | Facility | None | $1,288.25 | $1,288.25 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,288.25 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,218.10 | Facility | None | $8,511.38 | $12,302.69 | $16,218.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $8,511.38 | Facility | None | $616.60 | $630.96 | $8,511.38 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | None | $616.60 | $616.60 | $954.99 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,479.11 | Professional | None | $758.58 | $1,047.13 | $1,479.11 |
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 $436.52 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $645.65 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $602.56 | $912.01 | $912.01 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,230.27 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $144.54 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $912.01 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $912.01 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,659.59 Typical High $1,737.80 | Professional | 63 · Small infant | $1,380.38 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $229.09 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $218.78 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $186.21 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $218.78 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $194.98 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $436.52 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $173.78 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $645.65 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $128.82 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $87.10 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $602.56 | $912.01 | $912.01 |
Where Idaho sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.