How much rates vary
Facilitymedian $295 · 10th to 90th $107 to $1,202Professionalmedian $138 · 10th to 90th $98 to $288
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 $104.71 Median $223.87 Typical High $5,495.41 | Facility | None | $104.71 | $223.87 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $234.42 | Professional | None | $74.13 | $112.20 | $234.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $501.19 Typical High $1,202.26 | Facility | None | $112.20 | $501.19 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $309.03 | Professional | None | $107.15 | $199.53 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $245.47 | Professional | None | $100.00 | $138.04 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $138.04 Typical High $4,466.84 | Facility | None | $79.43 | $138.04 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $295.12 | Professional | None | $95.50 | $138.04 | $295.12 |
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 $93.33 Median $97.72 Typical High $245.47 | Facility | None | $93.33 | $97.72 | $245.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $288.40 | Professional | None | $97.72 | $169.82 | $288.40 |
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 $107.15 Median $147.91 Typical High $295.12 | Professional | None | $107.15 | $147.91 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $295.12 | Facility | None | $138.04 | $138.04 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
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 $79.43 Median $134.90 Typical High $234.42 | Professional | None | $79.43 | $134.90 | $234.42 |
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 $54.95 Median $74.13 Typical High $117.49 | Professional | 52 · Reduced service | $54.95 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $29.51 Typical High $46.77 | Professional | 53 · Discontinued | $21.88 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $109.65 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.79 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.96 | $14.79 | $23.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $109.65 Typical High $288.40 | Professional | 54 · Surgery only | $95.50 | $109.65 | $288.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $10.47 | $22.91 | $30.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $128.82 Median $154.88 Typical High $371.54 | Professional | 63 · Small infant | $128.82 | $154.88 | $371.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $74.13 | $181.97 | $223.87 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $20.42 Typical High $50.12 | Professional | 80 · Assistant surgeon | $16.98 | $20.42 | $50.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $19.95 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $17.38 | $19.95 | $47.86 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $40.74 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $40.74 | $51.29 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $14.45 Median $16.98 Typical High $40.74 | Professional | AS · PA/NP assist | $14.45 | $16.98 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $117.49 | Professional | 52 · Reduced service | $54.95 | $54.95 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $46.77 | Professional | 53 · Discontinued | $21.88 | $21.88 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $81.28 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $35.48 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $23.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $181.97 | Professional | 54 · Surgery only | $85.11 | $85.11 | $181.97 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $25.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $91.20 | $91.20 | $194.98 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 13th of 51
$162
AK $355MD $100
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.