How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,549 to $14,125Professionalmedian $1,413 · 10th to 90th $977 to $1,820
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 $1,862.09 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,862.09 | $1,862.09 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,548.82 | Professional | None | $891.25 | $1,230.27 | $1,548.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,801.89 Median $5,495.41 Typical High $14,791.08 | Facility | None | $3,801.89 | $5,495.41 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,621.81 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,288.25 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,023.29 | $1,862.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $1,862.09 | Professional | None | $977.24 | $1,548.82 | $1,862.09 |
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 $1,258.93 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,258.93 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,548.82 | $2,691.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,380.38 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $7,943.28 | Facility | None | $741.31 | $758.58 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Professional | None | $741.31 | $741.31 | $1,148.15 |
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 $891.25 Median $1,318.26 Typical High $1,862.09 | Professional | None | $891.25 | $1,318.26 | $1,862.09 |
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 $524.81 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $524.81 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $158.49 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $104.71 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $1,096.48 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,995.26 Typical High $2,089.30 | Professional | 63 · Small infant | $1,659.59 | $1,995.26 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $1,148.15 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $281.84 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $263.03 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $223.87 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $263.03 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $524.81 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $158.49 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $104.71 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $1,096.48 | $1,096.48 |
Where Idaho sits
The same service costs 4.2 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 $11,551MT $2,762
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.