How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,349 to $30,903Professionalmedian $955 · 10th to 90th $457 to $9,333
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 $457.09 Median $933.25 Typical High $6,165.95 | Professional | None | $457.09 | $933.25 | $6,165.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,454.71 Median $12,589.25 Typical High $35,481.34 | Facility | None | $2,454.71 | $12,589.25 | $35,481.34 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $6,456.54 Typical High $10,000.00 | Professional | None | $776.25 | $6,456.54 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $9,549.93 Median $10,715.19 Typical High $14,454.40 | Facility | None | $9,549.93 | $10,715.19 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $3,715.35 | Professional | None | $457.09 | $630.96 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $1,412.54 Typical High $7,079.46 | Facility | None | $223.87 | $1,412.54 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $7,943.28 | Professional | None | $741.31 | $954.99 | $7,943.28 |
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 $831.76 Median $831.76 Typical High $9,332.54 | Facility | None | $831.76 | $831.76 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $1,862.09 Typical High $11,748.98 | Professional | None | $831.76 | $1,862.09 | $11,748.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $21,877.62 Median $30,902.95 Typical High $44,668.36 | Facility | None | $21,877.62 | $30,902.95 | $44,668.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $7,762.47 | Professional | None | $912.01 | $1,096.48 | $7,762.47 |
Select Health Setting Facility Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $11,481.54 | Facility | None | $4,466.84 | $4,570.88 | $11,481.54 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $4,466.84 Typical High $9,772.37 | Professional | None | $436.52 | $4,466.84 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $3,019.95 | Professional | None | $218.78 | $389.05 | $3,019.95 |
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 $223.87 Median $467.74 Typical High $3,090.30 | Professional | 52 · Reduced service | $223.87 | $467.74 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $186.21 Typical High $1,230.27 | Professional | 53 · Discontinued | $91.20 | $186.21 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $691.83 Typical High $4,570.88 | Professional | 54 · Surgery only | $338.84 | $691.83 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $138.04 Typical High $933.25 | Professional | 55 · Aftercare only | $67.61 | $138.04 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $93.33 Typical High $616.60 | Professional | 56 · Pre-op care only | $45.71 | $93.33 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $645.65 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $316.23 | $645.65 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $6,456.54 Typical High $9,332.54 | Professional | 54 · Surgery only | $691.83 | $6,456.54 | $9,332.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $1,000.00 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,122.02 Typical High $11,481.54 | Professional | 63 · Small infant | $933.25 | $1,122.02 | $11,481.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $5,011.87 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $549.54 | $5,011.87 | $6,918.31 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $1,148.15 Typical High $1,621.81 | Professional | 80 · Assistant surgeon | $123.03 | $1,148.15 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $1,148.15 Typical High $1,621.81 | Professional | 81 · Minimal assistant surgeon | $123.03 | $1,148.15 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $147.91 Typical High $1,584.89 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $147.91 | $1,584.89 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $144.54 Typical High $1,380.38 | Professional | AS · PA/NP assist | $104.71 | $144.54 | $1,380.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $467.74 Typical High $3,090.30 | Professional | 52 · Reduced service | $223.87 | $467.74 | $3,090.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $186.21 Typical High $1,230.27 | Professional | 53 · Discontinued | $91.20 | $186.21 | $1,230.27 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $691.83 Typical High $4,570.88 | Professional | 54 · Surgery only | $338.84 | $691.83 | $4,570.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $138.04 Typical High $933.25 | Professional | 55 · Aftercare only | $67.61 | $138.04 | $933.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $93.33 Typical High $616.60 | Professional | 56 · Pre-op care only | $45.71 | $93.33 | $616.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $645.65 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $316.23 | $645.65 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $6,606.93 | Professional | 54 · Surgery only | $741.31 | $741.31 | $6,606.93 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $933.25 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $7,079.46 |
Where Idaho sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.