How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $5,495Professionalmedian $891 · 10th to 90th $537 to $1,259
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 $478.63 Median $977.24 Typical High $1,258.93 | Professional | None | $478.63 | $977.24 | $1,258.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $6,025.60 | Facility | None | $1,412.54 | $2,041.74 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,288.25 | Professional | None | $741.31 | $1,071.52 | $1,288.25 |
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 $446.68 Median $707.95 Typical High $933.25 | Professional | None | $446.68 | $707.95 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $5,495.41 | Facility | None | $524.81 | $1,023.29 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $1,258.93 | Professional | None | $512.86 | $977.24 | $1,258.93 |
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 $776.25 Median $1,148.15 Typical High $2,041.74 | Facility | None | $776.25 | $1,148.15 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,445.44 | Professional | None | $676.08 | $1,000.00 | $1,445.44 |
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 $758.58 Median $954.99 Typical High $1,174.90 | Professional | None | $758.58 | $954.99 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $3,630.78 | Facility | None | $549.54 | $562.34 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $2,041.74 | Professional | None | $549.54 | $741.31 | $2,041.74 |
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 $489.78 Median $691.83 Typical High $1,047.13 | Professional | None | $489.78 | $691.83 | $1,047.13 |
26 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 $489.78 Typical High $630.96 | Professional | 52 · Reduced service | $457.09 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $181.97 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $954.99 | Professional | 54 · Surgery only | $691.83 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $190.55 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $891.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,089.30 Median $3,019.95 Typical High $9,120.11 | Facility | 50 · Both sides | $2,089.30 | $3,019.95 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $1,071.52 | $1,659.59 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $645.65 | $776.25 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $74.13 | $109.65 | $144.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $1,047.13 Typical High $1,737.80 | Professional | 63 · Small infant | $851.14 | $1,047.13 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $501.19 | $758.58 | $870.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $169.82 Typical High $199.53 | Professional | 80 · Assistant surgeon | $117.49 | $169.82 | $199.53 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $169.82 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $114.82 | $169.82 | $208.93 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $138.04 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $138.04 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $177.83 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $489.78 Typical High $630.96 | Professional | 52 · Reduced service | $457.09 | $489.78 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $181.97 | $194.98 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $954.99 | Professional | 54 · Surgery only | $691.83 | $724.44 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $190.55 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,698.24 Typical High $2,187.76 | Professional | 50 · Both sides | $1,698.24 | $1,698.24 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $1,023.29 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,096.48 |
Where Idaho sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.