How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,089 to $14,125Professionalmedian $2,239 · 10th to 90th $1,479 to $2,692
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 $4,466.84 Median $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,380.38 | $2,137.96 | $2,511.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,570.40 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,659.59 | $2,089.30 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,511.89 Typical High $5,495.41 | Facility | None | $1,202.26 | $2,511.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,344.23 | $2,511.89 |
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 $2,041.74 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,041.74 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,344.23 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,344.23 | Professional | None | $2,187.76 | $2,187.76 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $10,964.78 | Facility | None | $1,202.26 | $1,230.27 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,202.26 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,348.96 | $2,041.74 | $2,818.38 |
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 $741.31 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $741.31 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $295.12 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,096.48 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $218.78 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $147.91 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $7,585.78 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $7,585.78 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $3,981.07 Typical High $5,248.07 | Professional | 50 · Both sides | $3,388.44 | $3,981.07 | $5,248.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,398.83 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,041.74 | $2,398.83 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $269.15 | $281.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,235.94 Typical High $3,388.44 | Professional | 63 · Small infant | $2,691.53 | $3,235.94 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $363.08 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $363.08 Typical High $380.19 | Professional | AS · PA/NP assist | $309.03 | $363.08 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $954.99 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $380.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,445.44 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $288.40 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $190.55 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 3.1 times more in Alaska than in Delaware. 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 $12,999DE $4,240
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.