How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,202 to $9,120Professionalmedian $1,380 · 10th to 90th $692 to $1,778
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 $691.83 Median $1,778.28 Typical High $1,778.28 | Professional | None | $691.83 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,584.89 Median $4,265.80 Typical High $10,964.78 | Facility | None | $1,584.89 | $4,265.80 | $10,964.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,584.89 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $2,398.83 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,288.25 | Professional | None | $588.84 | $1,122.02 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $5,495.41 | Facility | None | $831.76 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $1,778.28 | Professional | None | $724.44 | $1,380.38 | $1,778.28 |
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 $1,412.54 Median $1,412.54 Typical High $4,265.80 | Facility | None | $1,412.54 | $1,412.54 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,412.54 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,471.29 Typical High $13,182.57 | Facility | None | $7,585.78 | $10,471.29 | $13,182.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,621.81 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $5,495.41 | Facility | None | $676.08 | $691.83 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $4,265.80 | Professional | None | $676.08 | $1,047.13 | $4,265.80 |
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 $758.58 Median $1,023.29 Typical High $1,479.11 | Professional | None | $758.58 | $1,023.29 | $1,479.11 |
22 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 $630.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $630.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $251.19 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $125.89 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,398.83 Median $6,309.57 Typical High $16,982.44 | Facility | 50 · Both sides | $2,398.83 | $6,309.57 | $16,982.44 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,344.23 Typical High $3,090.30 | Professional | 50 · Both sides | $1,995.26 | $2,344.23 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $204.17 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,819.70 Typical High $2,454.71 | Professional | 63 · Small infant | $1,548.82 | $1,819.70 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $323.59 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $323.59 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $245.47 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $204.17 | $245.47 | $323.59 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $245.47 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $245.47 | $323.59 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $630.96 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $251.19 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $954.99 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $190.55 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $125.89 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $891.25 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $1,633
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.