How much rates vary
Facilitymedian $151 · 10th to 90th $76 to $513Professionalmedian $89 · 10th to 90th $62 to $219
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 $87.10 Median $223.87 Typical High $5,495.41 | Facility | None | $87.10 | $223.87 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $177.83 | Professional | None | $50.12 | $79.43 | $177.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $512.86 | Facility | None | $75.86 | $123.03 | $512.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $234.42 | Professional | None | $69.18 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $102.33 Typical High $141.25 | Facility | None | $91.20 | $102.33 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $186.21 | Professional | None | $63.10 | $87.10 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $100.00 Typical High $4,466.84 | Facility | None | $38.90 | $100.00 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $223.87 | Professional | None | $60.26 | $89.13 | $223.87 |
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 $58.88 Median $61.66 Typical High $186.21 | Facility | None | $58.88 | $61.66 | $186.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $61.66 Median $128.82 Typical High $218.78 | Professional | None | $61.66 | $128.82 | $218.78 |
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 $69.18 Median $95.50 Typical High $223.87 | Professional | None | $69.18 | $95.50 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $194.98 | Facility | None | $104.71 | $104.71 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
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 $48.98 Median $87.10 Typical High $173.78 | Professional | None | $48.98 | $87.10 | $173.78 |
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 $34.67 Median $56.23 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.39 Typical High $35.48 | Professional | 53 · Discontinued | $14.13 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $85.11 Typical High $134.90 | Professional | 54 · Surgery only | $52.48 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $26.92 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $11.22 | $17.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $147.91 Typical High $213.80 | Professional | 54 · Surgery only | $61.66 | $147.91 | $213.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.76 Typical High $17.78 | Professional | 55 · Aftercare only | $6.76 | $7.76 | $17.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $79.43 Median $95.50 Typical High $295.12 | Professional | 63 · Small infant | $79.43 | $95.50 | $295.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $53.70 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $46.77 | $53.70 | $165.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $12.59 Typical High $38.90 | Professional | 80 · Assistant surgeon | $10.72 | $12.59 | $38.90 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $31.62 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $12.02 | $31.62 | $38.90 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $12.30 Typical High $36.31 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $12.30 | $36.31 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $9.12 Median $10.47 Typical High $28.18 | Professional | AS · PA/NP assist | $9.12 | $10.47 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $34.67 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $35.48 | Professional | 53 · Discontinued | $14.13 | $14.13 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $134.90 | Professional | 54 · Surgery only | $52.48 | $52.48 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $26.92 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $17.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $138.04 | Professional | 54 · Surgery only | $53.70 | $53.70 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $19.50 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $147.91 |
Where Idaho sits
The same service costs 3.5 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
$115
AK $229KY $66.07
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.