How much rates vary
Facilitymedian $14,125 · 10th to 90th $1,072 to $56,234Professionalmedian $603 · 10th to 90th $398 to $759
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 $398.11 Median $758.58 Typical High $758.58 | Professional | None | $398.11 | $758.58 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,951.21 Median $28,183.83 Typical High $57,543.99 | Facility | None | $2,951.21 | $28,183.83 | $57,543.99 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $676.08 | Professional | None | $549.54 | $630.96 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $14,791.08 Median $16,595.87 Typical High $23,442.29 | Facility | None | $14,791.08 | $16,595.87 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $489.78 | Professional | None | $371.54 | $426.58 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $758.58 Typical High $5,495.41 | Facility | None | $346.74 | $758.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $758.58 | Professional | None | $398.11 | $741.31 | $758.58 |
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 $489.78 Median $602.56 Typical High $602.56 | Facility | None | $489.78 | $602.56 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | None | $602.56 | $602.56 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $39,810.72 Median $56,234.13 Typical High $70,794.58 | Facility | None | $39,810.72 | $56,234.13 | $70,794.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $741.31 | Professional | None | $588.84 | $630.96 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $9,772.37 | Facility | None | $281.84 | $288.40 | $9,772.37 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $15,135.61 | Professional | None | $281.84 | $309.03 | $15,135.61 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $630.96 | Professional | None | $323.59 | $446.68 | $630.96 |
20 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 $199.53 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $199.53 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $79.43 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $295.12 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $58.88 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $39.81 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $275.42 | $524.81 | $524.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $549.54 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $741.31 Typical High $794.33 | Professional | 63 · Small infant | $660.69 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $467.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 80 · Assistant surgeon | $89.13 | $97.72 | $107.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $89.13 | $97.72 | $107.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $97.72 | $107.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $83.18 Typical High $91.20 | Professional | AS · PA/NP assist | $74.13 | $83.18 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $199.53 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $79.43 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $295.12 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $58.88 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $39.81 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $275.42 | $524.81 | $524.81 |
Where Idaho sits
The same service costs 29.1 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 $30,626MT $1,051
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.