How much rates vary
Facilitymedian $2,138 · 10th to 90th $457 to $7,943Professionalmedian $447 · 10th to 90th $295 to $813
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 $457.09 Median $912.01 Typical High $5,495.41 | Facility | None | $457.09 | $912.01 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $758.58 | Professional | None | $257.04 | $407.38 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,467.37 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $870.96 | Professional | None | $338.84 | $660.69 | $870.96 |
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 $309.03 Median $426.58 Typical High $676.08 | Professional | None | $309.03 | $426.58 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $758.58 Typical High $8,511.38 | Facility | None | $331.13 | $758.58 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $870.96 | Professional | None | $288.40 | $457.09 | $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 $380.19 Median $380.19 Typical High $776.25 | Facility | None | $380.19 | $380.19 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $831.76 | Professional | None | $380.19 | $660.69 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,079.46 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,079.46 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $724.44 | Professional | None | $338.84 | $467.74 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $5,623.41 | Facility | None | $363.08 | $371.54 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $512.86 | Professional | None | $239.88 | $363.08 | $512.86 |
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 $269.15 Median $446.68 Typical High $724.44 | Professional | None | $269.15 | $446.68 | $724.44 |
15 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 $128.82 Median $190.55 Typical High $380.19 | Professional | 52 · Reduced service | $128.82 | $190.55 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $51.29 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $575.44 | Professional | 54 · Surgery only | $194.98 | $288.40 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $38.90 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $75.86 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $75.86 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $316.23 | $660.69 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $81.28 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $81.28 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $257.04 Typical High $537.03 | Professional | 62 · Two surgeons | $218.78 | $257.04 | $537.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $416.87 Median $512.86 Typical High $1,000.00 | Professional | 63 · Small infant | $416.87 | $512.86 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $295.12 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $295.12 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $190.55 Typical High $380.19 | Professional | 52 · Reduced service | $128.82 | $190.55 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $51.29 | $75.86 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $575.44 | Professional | 54 · Surgery only | $194.98 | $288.40 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $38.90 | $57.54 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $75.86 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $75.86 |
Where Idaho sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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 $4,893WV $835
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.