How much rates vary
Facilitymedian $1,479 · 10th to 90th $759 to $6,026Professionalmedian $741 · 10th to 90th $468 to $933
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 $660.69 Median $933.25 Typical High $933.25 | Professional | None | $660.69 | $933.25 | $933.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,344.23 Typical High $6,025.60 | Facility | None | $1,412.54 | $2,344.23 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,096.48 | Professional | None | $691.83 | $831.76 | $1,096.48 |
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 $346.74 Median $616.60 Typical High $691.83 | Professional | None | $346.74 | $616.60 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $933.25 Typical High $5,495.41 | Facility | None | $467.74 | $933.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $933.25 | Professional | None | $630.96 | $724.44 | $933.25 |
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 $616.60 Median $741.31 Typical High $741.31 | Facility | None | $616.60 | $741.31 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,096.48 | Professional | None | $645.65 | $741.31 | $1,096.48 |
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 $724.44 Median $870.96 Typical High $870.96 | Professional | None | $724.44 | $870.96 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $3,890.45 | Facility | None | $354.81 | $363.08 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $1,445.44 | Professional | None | $354.81 | $562.34 | $1,445.44 |
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 $467.74 Median $602.56 Typical High $870.96 | Professional | None | $467.74 | $602.56 | $870.96 |
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 $331.13 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $660.69 | $660.69 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,089.30 Median $3,467.37 Typical High $9,120.11 | Facility | 50 · Both sides | $2,089.30 | $3,467.37 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $1,659.59 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $977.24 | Professional | 54 · Surgery only | $602.56 | $724.44 | $977.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $109.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $812.83 Median $954.99 Typical High $1,318.26 | Professional | 63 · Small infant | $812.83 | $954.99 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $467.74 | $562.34 | $758.58 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $173.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $107.15 | $128.82 | $173.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $128.82 | $173.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $147.91 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $512.86 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $660.69 | $660.69 |
Where Idaho sits
The same service costs 4.3 times more in Oklahoma 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
OK $5,618MT $1,306
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.