How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,995 to $16,218Professionalmedian $2,042 · 10th to 90th $1,413 to $2,692
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 $3,235.94 Typical High $7,762.47 | Facility | None | $2,884.03 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,174.90 | $2,691.53 | $2,691.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $7,079.46 Typical High $18,620.87 | Facility | None | $4,073.80 | $7,079.46 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,137.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,548.82 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,235.94 Typical High $6,456.54 | Facility | None | $1,174.90 | $3,235.94 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $2,691.53 | Professional | None | $1,445.44 | $2,570.40 | $2,691.53 |
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 $2,630.27 | Professional | None | $1,995.26 | $1,995.26 | $2,630.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,238.72 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $10,715.19 | Facility | None | $954.99 | $954.99 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $4,168.69 | Professional | None | $954.99 | $1,071.52 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,288.25 | $2,818.38 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,698.24 | $2,344.23 |
23 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 $724.44 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $724.44 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $288.40 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,071.52 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $218.78 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $144.54 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,456.54 Median $10,471.29 Typical High $28,183.83 | Facility | 50 · Both sides | $6,456.54 | $10,471.29 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,090.30 Typical High $3,311.31 | Professional | 50 · Both sides | $2,754.23 | $3,090.30 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,862.09 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $223.87 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,288.25 Typical High $1,380.38 | Professional | 62 · Two surgeons | $1,148.15 | $1,288.25 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,187.76 Median $2,454.71 Typical High $2,691.53 | Professional | 63 · Small infant | $2,187.76 | $2,454.71 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,445.44 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,445.44 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $331.13 Typical High $354.81 | Professional | 80 · Assistant surgeon | $295.12 | $331.13 | $354.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $331.13 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $295.12 | $331.13 | $354.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $331.13 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $331.13 | $354.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | AS · PA/NP assist | $251.19 | $281.84 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $724.44 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $288.40 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,071.52 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $218.78 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $144.54 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,905.46 | $1,905.46 |
Where Idaho sits
The same service costs 5.0 times more in Colorado 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
CO $14,731KY $2,968
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.