How much rates vary
Facilitymedian $166 · 10th to 90th $78 to $1,047Professionalmedian $112 · 10th to 90th $71 to $195
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 $64.57 Median $97.72 Typical High $154.88 | Professional | None | $64.57 | $97.72 | $154.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $83.18 Median $275.42 Typical High $1,047.13 | Facility | None | $83.18 | $275.42 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $213.80 | Professional | None | $83.18 | $151.36 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $107.15 | Facility | None | $69.18 | $77.62 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $162.18 | Professional | None | $77.62 | $112.20 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $151.36 Typical High $5,495.41 | Facility | None | $69.18 | $151.36 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $194.98 | Professional | None | $69.18 | $134.90 | $194.98 |
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 $74.13 Median $77.62 Typical High $165.96 | Facility | None | $74.13 | $77.62 | $165.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $194.98 | Professional | None | $77.62 | $93.33 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $194.98 | Professional | None | $83.18 | $114.82 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $380.19 | Facility | None | $93.33 | $95.50 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $125.89 | Professional | None | $56.23 | $93.33 | $125.89 |
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 $63.10 Median $117.49 Typical High $218.78 | Professional | None | $63.10 | $117.49 | $218.78 |
18 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 $34.67 Median $41.69 Typical High $77.62 | Professional | 52 · Reduced service | $34.67 | $41.69 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $30.90 | Professional | 53 · Discontinued | $13.80 | $16.98 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $117.49 | Professional | 54 · Surgery only | $51.29 | $63.10 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $23.44 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $15.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $89.13 | $162.18 | $199.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.77 Typical High $21.38 | Professional | 55 · Aftercare only | $8.32 | $9.77 | $21.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $100.00 Median $117.49 Typical High $223.87 | Professional | 63 · Small infant | $100.00 | $117.49 | $223.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $58.88 | $125.89 | $154.88 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $16.22 Typical High $33.88 | Professional | 80 · Assistant surgeon | $13.18 | $16.22 | $33.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $16.22 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $13.18 | $16.22 | $33.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $16.22 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $16.22 | $33.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $11.22 Median $13.80 Typical High $28.84 | Professional | AS · PA/NP assist | $11.22 | $13.80 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $41.69 Typical High $77.62 | Professional | 52 · Reduced service | $34.67 | $41.69 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $30.90 | Professional | 53 · Discontinued | $13.80 | $16.98 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $117.49 | Professional | 54 · Surgery only | $51.29 | $63.10 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $23.44 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $15.49 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 17th of 51
$126
AK $257PA $93.33
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.