How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,089 to $14,125Professionalmedian $2,291 · 10th to 90th $1,514 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 $2,570.40 Typical High $2,570.40 | Professional | None | $1,380.38 | $2,570.40 | $2,570.40 |
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 $2,137.96 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,137.96 | $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 $2,570.40 Typical High $5,495.41 | Facility | None | $1,202.26 | $2,570.40 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,344.23 | $2,570.40 |
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 $2,290.87 Typical High $2,290.87 | Facility | None | $2,041.74 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,290.87 | $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 $2,137.96 Median $2,137.96 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,137.96 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $10,964.78 | Facility | None | $1,202.26 | $1,202.26 | $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 $1,318.26 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,995.26 | $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 $758.58 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $758.58 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $302.00 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,122.02 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $223.87 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $151.36 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,047.13 | $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 $263.03 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,162.28 Typical High $3,388.44 | Professional | 63 · Small infant | $2,691.53 | $3,162.28 | $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 $302.00 Median $363.08 Typical High $380.19 | Professional | AS · PA/NP assist | $302.00 | $363.08 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $389.05 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,479.11 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $194.98 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.