How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,230 to $12,303Professionalmedian $1,862 · 10th to 90th $1,288 to $2,291
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,174.90 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $6,309.57 Typical High $15,135.61 | Facility | None | $3,548.13 | $6,309.57 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,089.30 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,801.89 | Facility | None | $2,511.89 | $2,818.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,698.24 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $5,495.41 | Facility | None | $1,288.25 | $2,041.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,380.38 | $2,041.74 | $2,290.87 |
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 $1,621.81 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,995.26 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,995.26 | $1,995.26 | $3,548.13 |
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 $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $977.24 Typical High $6,309.57 | Facility | None | $954.99 | $977.24 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,479.11 | Professional | None | $954.99 | $954.99 | $1,479.11 |
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 $1,148.15 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,659.59 | $2,398.83 |
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 $691.83 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $691.83 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $275.42 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,023.29 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $138.04 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $954.99 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,905.46 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,621.81 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $223.87 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,318.26 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,122.02 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,137.96 Median $2,570.40 Typical High $2,691.53 | Professional | 63 · Small infant | $2,137.96 | $2,570.40 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $302.00 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $691.83 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $275.42 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,023.29 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $204.17 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $138.04 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $954.99 | $1,445.44 | $1,445.44 |
Where Idaho sits
The same service costs 4.4 times more in Alaska 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
AK $10,675KY $2,405
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.