How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,622 to $14,125Professionalmedian $1,622 · 10th to 90th $1,148 to $1,995
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 $1,047.13 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,862.09 | $1,862.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,754.40 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,819.70 | $1,995.26 |
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 $1,288.25 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,513.56 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,071.52 | $1,862.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,737.80 | $1,862.09 |
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 $1,445.44 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $3,388.44 | Professional | None | $1,548.82 | $1,621.81 | $3,388.44 |
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 $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,584.89 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $10,964.78 | Facility | None | $851.14 | $851.14 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,318.26 | Professional | None | $851.14 | $851.14 | $1,318.26 |
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 $1,000.00 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,513.56 | $2,187.76 |
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 $537.03 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $537.03 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $213.80 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $794.33 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $158.49 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $107.15 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $741.31 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $8,128.31 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $8,128.31 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,884.03 Typical High $3,801.89 | Professional | 50 · Both sides | $2,398.83 | $2,884.03 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,698.24 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,905.46 Median $2,238.72 Typical High $2,398.83 | Professional | 63 · Small infant | $1,905.46 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,318.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,318.26 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $302.00 Typical High $316.23 | Professional | 80 · Assistant surgeon | $251.19 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $302.00 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $251.19 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $302.00 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $257.04 Typical High $269.15 | Professional | AS · PA/NP assist | $213.80 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $275.42 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,023.29 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $204.17 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $138.04 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $954.99 | $1,288.25 | $1,288.25 |
Where Idaho sits
The same service costs 3.6 times more in Alaska 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
AK $11,248MT $3,134
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.