How much rates vary
Facilitymedian $1,413 · 10th to 90th $1,047 to $5,012Professionalmedian $1,288 · 10th to 90th $912 to $1,738
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 $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $1,737.80 | Professional | None | $758.58 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $5,011.87 | Facility | None | $1,288.25 | $2,187.76 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,412.54 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,584.89 | Facility | None | $1,047.13 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,148.15 | Professional | None | $891.25 | $1,000.00 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $5,495.41 | Facility | None | $758.58 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $1,737.80 | Professional | None | $912.01 | $1,737.80 | $1,737.80 |
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 $1,047.13 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,047.13 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,388.44 Median $4,897.79 Typical High $6,309.57 | Facility | None | $3,388.44 | $4,897.79 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $4,265.80 | Facility | None | $616.60 | $630.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,122.02 | Professional | None | $616.60 | $724.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $776.25 | $1,047.13 | $1,479.11 |
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 $457.09 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $457.09 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $186.21 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $691.83 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $138.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $91.20 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $645.65 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $144.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,659.59 Typical High $1,737.80 | Professional | 63 · Small infant | $1,445.44 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $954.99 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $190.55 | $218.78 | $234.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $190.55 | $218.78 | $234.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $218.78 | $234.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $186.21 Typical High $194.98 | Professional | AS · PA/NP assist | $162.18 | $186.21 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $457.09 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $186.21 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $691.83 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $138.04 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $91.20 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $645.65 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 3.0 times more in Alaska than in Maryland. 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
AK $5,643MD $1,856
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.