How much rates vary
Facilitymedian $1,349 · 10th to 90th $219 to $5,495Professionalmedian $214 · 10th to 90th $138 to $309
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $309.03 | Professional | None | $218.78 | $223.87 | $309.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $6,025.60 | Facility | None | $1,096.48 | $1,819.70 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $316.23 | Professional | None | $162.18 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $223.87 | Professional | None | $112.20 | $162.18 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $309.03 Typical High $5,495.41 | Facility | None | $97.72 | $309.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $309.03 | Professional | None | $151.36 | $218.78 | $309.03 |
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 $169.82 Median $169.82 Typical High $281.84 | Facility | None | $169.82 | $169.82 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $354.81 | Professional | None | $147.91 | $245.47 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $7,585.78 | Facility | None | $3,890.45 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $288.40 | Professional | None | $169.82 | $213.80 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $3,890.45 | Facility | None | $134.90 | $138.04 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $1,445.44 | Professional | None | $134.90 | $181.97 | $1,445.44 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $263.03 | Professional | None | $112.20 | $165.96 | $263.03 |
24 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 $109.65 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $109.65 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 54 · Surgery only | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $30.90 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,621.81 Median $2,511.89 Typical High $9,120.11 | Facility | 50 · Both sides | $1,621.81 | $2,511.89 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $389.05 Typical High $537.03 | Professional | 50 · Both sides | $245.47 | $389.05 | $537.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $147.91 | $229.09 | $275.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $35.48 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $35.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $229.09 Typical High $346.74 | Professional | 63 · Small infant | $190.55 | $229.09 | $346.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $131.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $109.65 | $131.83 | $208.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $34.67 Typical High $50.12 | Professional | 80 · Assistant surgeon | $25.12 | $34.67 | $50.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $40.74 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $28.18 | $40.74 | $48.98 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $30.90 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $30.90 | $47.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $26.30 Typical High $36.31 | Professional | AS · PA/NP assist | $21.38 | $26.30 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $109.65 | $109.65 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $43.65 | $43.65 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 54 · Surgery only | $162.18 | $162.18 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $30.90 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $380.19 Typical High $537.03 | Professional | 50 · Both sides | $380.19 | $380.19 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $177.83 | $177.83 | $251.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $35.48 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $269.15 |
Where Idaho sits
The same service costs 10.9 times more in Colorado 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
CO $3,950MT $363
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.