How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,291 to $16,218Professionalmedian $2,291 · 10th to 90th $1,585 to $3,090
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 $3,235.94 Median $3,630.78 Typical High $6,456.54 | Facility | None | $3,235.94 | $3,630.78 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $3,090.30 | Professional | None | $1,288.25 | $3,090.30 | $3,090.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $6,918.31 Typical High $18,620.87 | Facility | None | $4,897.79 | $6,918.31 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,454.71 | $2,630.27 |
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 $1,584.89 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,737.80 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $3,630.78 Typical High $9,549.93 | Facility | None | $1,621.81 | $3,630.78 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $3,019.95 Typical High $3,090.30 | Professional | None | $1,621.81 | $3,019.95 | $3,090.30 |
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 $1,862.09 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,862.09 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,090.30 | Professional | None | $2,290.87 | $2,290.87 | $3,090.30 |
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 $2,454.71 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,630.27 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $12,022.64 | Facility | None | $1,096.48 | $1,122.02 | $12,022.64 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $4,168.69 | Professional | None | $1,096.48 | $1,258.93 | $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 $1,380.38 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,905.46 | $2,630.27 |
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 $812.83 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $812.83 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $323.59 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,202.26 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $239.88 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $162.18 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $10,232.93 Typical High $28,183.83 | Facility | 50 · Both sides | $7,413.10 | $10,232.93 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,630.78 Typical High $3,801.89 | Professional | 50 · Both sides | $3,162.28 | $3,630.78 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,137.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,905.46 | $2,137.96 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,513.56 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,318.26 | $1,513.56 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 63 · Small infant | $2,511.89 | $2,884.03 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,659.59 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $380.19 Typical High $407.38 | Professional | 80 · Assistant surgeon | $338.84 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $380.19 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $338.84 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $380.19 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $323.59 Typical High $346.74 | Professional | AS · PA/NP assist | $288.40 | $323.59 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $812.83 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $323.59 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,202.26 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $239.88 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $162.18 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,137.96 | $2,137.96 |
Where Idaho sits
The same service costs 4.7 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 $15,002KY $3,224
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.