How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,291 to $16,218Professionalmedian $2,291 · 10th to 90th $1,514 to $3,020
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 $3,548.13 Median $4,365.16 Typical High $8,511.38 | Facility | None | $3,548.13 | $4,365.16 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $3,019.95 Typical High $3,019.95 | Professional | None | $1,258.93 | $3,019.95 | $3,019.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $7,413.10 Typical High $18,620.87 | Facility | None | $4,897.79 | $7,413.10 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,511.89 | $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 $1,548.82 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,737.80 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $4,265.80 Typical High $11,748.98 | Facility | None | $1,288.25 | $4,265.80 | $11,748.98 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,951.21 | $3,019.95 |
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 $2,951.21 | Professional | None | $2,454.71 | $2,630.27 | $2,951.21 |
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 $1,348.96 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,862.09 | $2,630.27 |
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 $794.33 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $794.33 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $316.23 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,202.26 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $239.88 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $158.49 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,089.30 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,137.96 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $2,137.96 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,479.11 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,348.96 | $1,479.11 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,570.40 Median $2,884.03 Typical High $3,090.30 | Professional | 63 · Small infant | $2,570.40 | $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 $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 80 · Assistant surgeon | $338.84 | $380.19 | $416.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $338.84 | $380.19 | $416.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $380.19 | $416.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | AS · PA/NP assist | $288.40 | $323.59 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $794.33 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $316.23 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,202.26 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $239.88 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $158.49 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,089.30 | $2,089.30 |
Where Idaho sits
The same service costs 4.6 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 $14,661KY $3,164
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.