How much rates vary
Facilitymedian $380 · 10th to 90th $151 to $1,413Professionalmedian $282 · 10th to 90th $132 to $372
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 $234.42 Median $281.84 Typical High $281.84 | Professional | None | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $41.69 | $41.69 |
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 $131.83 Median $154.88 Typical High $281.84 | Professional | None | $131.83 | $154.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $141.25 | Professional | 54 · Surgery only | $120.23 | $134.90 | $141.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.79 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $14.79 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $316.23 | Professional | None | $234.42 | $281.84 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $281.84 Typical High $5,495.41 | Facility | None | $154.88 | $281.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $251.19 Typical High $281.84 | Professional | None | $81.28 | $251.19 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $41.69 | $41.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $114.82 Typical High $134.90 | Professional | None | $30.20 | $114.82 | $134.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $354.81 | Professional | None | $281.84 | $281.84 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Facility | None | $154.88 | $154.88 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $154.88 | Professional | None | $81.28 | $154.88 | $154.88 |
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 $190.55 Median $338.84 Typical High $467.74 | Professional | None | $190.55 | $338.84 | $467.74 |
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 $117.49 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $46.77 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.44 | $28.18 | $28.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $158.49 Median $177.83 Typical High $186.21 | Professional | 63 · Small infant | $158.49 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $93.33 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 80 · Assistant surgeon | $21.38 | $23.99 | $25.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $21.38 | $23.99 | $25.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $23.99 | $25.12 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $18.20 Median $19.95 Typical High $21.38 | Professional | AS · PA/NP assist | $18.20 | $19.95 | $21.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $117.49 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $46.77 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.44 | $28.18 | $28.18 |
Where Idaho sits
The same service costs 7.2 times more in Oklahoma than in 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.
Idaho· 29th of 51
$282
OK $1,000VA $138
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.