How much rates vary
Facilitymedian $251 · 10th to 90th $79 to $603Professionalmedian $115 · 10th to 90th $83 to $257
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 $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $213.80 | Professional | None | $72.44 | $104.71 | $213.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $288.40 Typical High $602.56 | Facility | None | $66.07 | $288.40 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $281.84 | Professional | None | $91.20 | $177.83 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $223.87 | Professional | None | $85.11 | $114.82 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $123.03 Typical High $4,466.84 | Facility | None | $67.61 | $123.03 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $263.03 | Professional | None | $79.43 | $114.82 | $263.03 |
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 $77.62 Median $83.18 Typical High $218.78 | Facility | None | $77.62 | $83.18 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $257.04 | Professional | None | $83.18 | $151.36 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $263.03 | Professional | None | $91.20 | $125.89 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $194.98 | Facility | None | $123.03 | $125.89 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
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 $67.61 Median $114.82 Typical High $213.80 | Professional | None | $67.61 | $114.82 | $213.80 |
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 $45.71 Median $66.07 Typical High $104.71 | Professional | 52 · Reduced service | $45.71 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $18.62 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $100.00 Typical High $158.49 | Professional | 54 · Surgery only | $69.18 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $21.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $89.13 | $208.93 | $257.04 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $20.89 Typical High $28.18 | Professional | 55 · Aftercare only | $10.00 | $20.89 | $28.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $107.15 Median $123.03 Typical High $346.74 | Professional | 63 · Small infant | $107.15 | $123.03 | $346.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $75.86 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $64.57 | $75.86 | $165.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $16.60 Typical High $45.71 | Professional | 80 · Assistant surgeon | $14.13 | $16.60 | $45.71 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.45 Median $37.15 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $14.45 | $37.15 | $42.66 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.13 Median $37.15 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $14.13 | $37.15 | $44.67 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $14.13 Typical High $38.90 | Professional | AS · PA/NP assist | $12.02 | $14.13 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $104.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $42.66 | Professional | 53 · Discontinued | $18.62 | $18.62 | $42.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $158.49 | Professional | 54 · Surgery only | $69.18 | $69.18 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $31.62 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $21.38 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $162.18 | Professional | 54 · Surgery only | $70.79 | $70.79 | $162.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $23.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $75.86 | $75.86 | $173.78 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 16th of 51
$141
AK $302NJ $85.11
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.