How much rates vary
Facilitymedian $380 · 10th to 90th $145 to $1,413Professionalmedian $186 · 10th to 90th $107 to $457
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $407.38 | Professional | None | $100.00 | $245.47 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $302.00 | Professional | 54 · Surgery only | $75.86 | $93.33 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $61.66 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $61.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $1,412.54 | Facility | None | $338.84 | $562.34 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $346.74 Typical High $501.19 | Professional | None | $109.65 | $346.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $323.59 Typical High $446.68 | Professional | 54 · Surgery only | $109.65 | $323.59 | $446.68 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $12.30 | $35.48 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $436.52 | Professional | None | $114.82 | $186.21 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $5,495.41 | Facility | None | $100.00 | $380.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $457.09 | Professional | None | $109.65 | $257.04 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $302.00 | Professional | 54 · Surgery only | $75.86 | $93.33 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $61.66 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $61.66 |
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 $104.71 Median $104.71 Typical High $371.54 | Facility | None | $104.71 | $104.71 | $371.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $457.09 | Professional | None | $109.65 | $128.82 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $457.09 | Professional | None | $109.65 | $141.25 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $223.87 | Facility | None | $218.78 | $218.78 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $295.12 | Professional | None | $81.28 | $218.78 | $295.12 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $91.20 Median $229.09 Typical High $489.78 | Professional | None | $91.20 | $229.09 | $489.78 |
12 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 $50.12 Median $61.66 Typical High $204.17 | Professional | 52 · Reduced service | $50.12 | $61.66 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $81.28 | Professional | 53 · Discontinued | $20.42 | $25.12 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $40.74 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $40.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $144.54 Median $173.78 Typical High $562.34 | Professional | 63 · Small infant | $144.54 | $173.78 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $251.19 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $83.18 | $251.19 | $346.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $22.39 Typical High $67.61 | Professional | 80 · Assistant surgeon | $19.05 | $22.39 | $67.61 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $23.44 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $19.05 | $23.44 | $77.62 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $57.54 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $57.54 | $81.28 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $19.05 Typical High $64.57 | Professional | AS · PA/NP assist | $16.22 | $19.05 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $61.66 Typical High $204.17 | Professional | 52 · Reduced service | $50.12 | $61.66 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $81.28 | Professional | 53 · Discontinued | $20.42 | $25.12 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $40.74 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $40.74 |
Where Idaho sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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.
Idaho· 11th of 51
$302
OK $575NE $129
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.