How much rates vary
Facilitymedian $251 · 10th to 90th $55 to $1,202Professionalmedian $68 · 10th to 90th $46 to $191
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 $66.07 Median $194.98 Typical High $5,495.41 | Facility | None | $66.07 | $194.98 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $162.18 | Professional | None | $42.66 | $64.57 | $162.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $389.05 Typical High $1,202.26 | Facility | None | $75.86 | $389.05 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $51.29 Median $131.83 Typical High $204.17 | Professional | None | $51.29 | $131.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $162.18 | Professional | None | $46.77 | $64.57 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $75.86 Typical High $831.76 | Facility | None | $33.88 | $75.86 | $831.76 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $66.07 Typical High $194.98 | Professional | None | $45.71 | $66.07 | $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 $44.67 Median $46.77 Typical High $162.18 | Facility | None | $44.67 | $46.77 | $162.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $112.20 Typical High $190.55 | Professional | None | $46.77 | $112.20 | $190.55 |
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 $51.29 Median $69.18 Typical High $194.98 | Professional | None | $51.29 | $69.18 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $194.98 | Facility | None | $89.13 | $91.20 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
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 $34.67 Median $72.44 Typical High $151.36 | Professional | None | $34.67 | $72.44 | $151.36 |
21 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 $26.30 Median $48.98 Typical High $77.62 | Professional | 52 · Reduced service | $26.30 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $19.50 Typical High $30.90 | Professional | 53 · Discontinued | $10.47 | $19.50 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $74.13 Typical High $117.49 | Professional | 54 · Surgery only | $38.90 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.79 Typical High $23.44 | Professional | 55 · Aftercare only | $7.94 | $14.79 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.77 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.25 | $9.77 | $15.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $52.48 | $151.36 | $181.97 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $5.13 | $16.98 | $20.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $63.10 Median $70.79 Typical High $208.93 | Professional | 63 · Small infant | $63.10 | $70.79 | $208.93 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $117.49 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $36.31 | $117.49 | $141.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.13 Median $26.30 Typical High $32.36 | Professional | 80 · Assistant surgeon | $8.13 | $26.30 | $32.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.13 Median $9.55 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $8.13 | $9.55 | $33.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $9.77 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $9.77 | $32.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $7.76 Typical High $21.88 | Professional | AS · PA/NP assist | $6.92 | $7.76 | $21.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.30 Typical High $77.62 | Professional | 52 · Reduced service | $26.30 | $26.30 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $30.90 | Professional | 53 · Discontinued | $10.47 | $10.47 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $117.49 | Professional | 54 · Surgery only | $38.90 | $38.90 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $23.44 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $15.49 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $117.49 | Professional | 54 · Surgery only | $40.74 | $40.74 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $43.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $43.65 | $43.65 | $125.89 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 14th of 51
$102
AK $170KY $51.29
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.