How much rates vary
Facilitymedian $1,000 · 10th to 90th $501 to $4,266Professionalmedian $457 · 10th to 90th $324 to $646
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $645.65 | Professional | None | $323.59 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $239.88 | $489.78 | $489.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $741.31 Median $1,230.27 Typical High $4,265.80 | Facility | None | $741.31 | $1,230.27 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $512.86 | Professional | None | $407.38 | $478.63 | $512.86 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $363.08 | $426.58 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $446.68 | Professional | None | $331.13 | $371.54 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $776.25 Typical High $5,495.41 | Facility | None | $281.84 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $630.96 Typical High $645.65 | Professional | None | $323.59 | $630.96 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $239.88 | $489.78 | $489.78 |
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 $363.08 Median $436.52 Typical High $436.52 | Facility | None | $363.08 | $436.52 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $645.65 | Professional | None | $436.52 | $436.52 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $630.96 | Professional | None | $478.63 | $512.86 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $2,884.03 | Facility | None | $208.93 | $213.80 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $831.76 | Professional | None | $208.93 | $263.03 | $831.76 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $575.44 | Professional | None | $288.40 | $407.38 | $575.44 |
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 $162.18 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $162.18 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $64.57 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $48.98 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $32.36 | $64.57 | $64.57 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $46.77 | $48.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $562.34 Typical High $588.84 | Professional | 63 · Small infant | $489.78 | $562.34 | $588.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $346.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $75.86 Typical High $79.43 | Professional | 80 · Assistant surgeon | $64.57 | $75.86 | $79.43 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $75.86 Typical High $79.43 | Professional | 81 · Minimal assistant surgeon | $64.57 | $75.86 | $79.43 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $75.86 Typical High $79.43 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $75.86 | $79.43 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | AS · PA/NP assist | $54.95 | $64.57 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $162.18 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $64.57 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $48.98 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $32.36 | $64.57 | $64.57 |
Where Idaho sits
The same service costs 6.0 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 $4,737MT $787
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.