How much rates vary
Facilitymedian $17,378 · 10th to 90th $1,995 to $39,811Professionalmedian $708 · 10th to 90th $479 to $912
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $912.01 Typical High $912.01 | Professional | None | $407.38 | $912.01 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,128.61 Median $29,512.09 Typical High $46,773.51 | Facility | None | $5,128.61 | $29,512.09 | $46,773.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $794.33 | Professional | None | $660.69 | $776.25 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $16,982.44 Median $19,054.61 Typical High $25,703.96 | Facility | None | $16,982.44 | $19,054.61 | $25,703.96 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | None | $478.63 | $524.81 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $4,466.84 Typical High $26,302.68 | Facility | None | $489.78 | $4,466.84 | $26,302.68 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $912.01 | Professional | None | $489.78 | $912.01 | $912.01 |
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 $707.95 Median $707.95 Typical High $29,512.09 | Facility | None | $707.95 | $707.95 | $29,512.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | None | $707.95 | $707.95 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $33,113.11 Median $45,708.82 Typical High $58,884.37 | Facility | None | $33,113.11 | $45,708.82 | $58,884.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $912.01 | Professional | None | $724.44 | $776.25 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $346.74 Typical High $9,772.37 | Facility | None | $338.84 | $346.74 | $9,772.37 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $17,378.01 | Professional | None | $338.84 | $380.19 | $17,378.01 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,232.93 Typical High $17,378.01 | Facility | None | $2,570.40 | $10,232.93 | $17,378.01 |
United Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $776.25 | Professional | None | $416.87 | $575.44 | $776.25 |
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 $239.88 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $239.88 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $97.72 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $363.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $72.44 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $48.98 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $338.84 | $645.65 | $645.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $660.69 | $707.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $79.43 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 62 · Two surgeons | $407.38 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $870.96 Typical High $954.99 | Professional | 63 · Small infant | $776.25 | $870.96 | $954.99 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $562.34 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $117.49 Typical High $125.89 | Professional | 80 · Assistant surgeon | $104.71 | $117.49 | $125.89 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $117.49 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $104.71 | $117.49 | $125.89 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $117.49 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $117.49 | $125.89 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $100.00 Typical High $107.15 | Professional | AS · PA/NP assist | $89.13 | $100.00 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $239.88 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $97.72 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $363.08 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $72.44 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $48.98 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $338.84 | $645.65 | $645.65 |
Where Idaho sits
The same service costs 29.4 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 $37,066MT $1,262
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.