How much rates vary
Facilitymedian $155 · 10th to 90th $85 to $513Professionalmedian $120 · 10th to 90th $85 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 $79.43 Median $100.00 Typical High $208.93 | Professional | None | $79.43 | $100.00 | $208.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $512.86 | Facility | None | $75.86 | $128.82 | $512.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $281.84 | Professional | None | $95.50 | $177.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $154.88 | Facility | None | $102.33 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $218.78 | Professional | None | $89.13 | $120.23 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $123.03 Typical High $4,466.84 | Facility | None | $69.18 | $123.03 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $263.03 | Professional | None | $83.18 | $120.23 | $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 $81.28 Median $85.11 Typical High $218.78 | Facility | None | $81.28 | $85.11 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $257.04 | Professional | None | $85.11 | $154.88 | $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 $95.50 Median $131.83 Typical High $263.03 | Professional | None | $95.50 | $131.83 | $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 $69.18 Median $112.20 Typical High $199.53 | Professional | None | $69.18 | $112.20 | $199.53 |
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 $47.86 Median $66.07 Typical High $104.71 | Professional | 52 · Reduced service | $47.86 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.30 Typical High $41.69 | Professional | 53 · Discontinued | $19.05 | $26.30 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $100.00 Typical High $158.49 | Professional | 54 · Surgery only | $72.44 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $14.45 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.18 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.55 | $13.18 | $20.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $239.88 | Professional | 54 · Surgery only | $87.10 | $102.33 | $239.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $23.44 Typical High $28.84 | Professional | 55 · Aftercare only | $9.55 | $23.44 | $28.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $112.20 Median $128.82 Typical High $295.12 | Professional | 63 · Small infant | $112.20 | $128.82 | $295.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $165.96 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $72.44 | $165.96 | $204.17 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $18.20 Typical High $44.67 | Professional | 80 · Assistant surgeon | $14.79 | $18.20 | $44.67 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $31.62 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $15.14 | $31.62 | $46.77 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $33.11 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $33.11 | $46.77 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $12.88 Median $15.49 Typical High $32.36 | Professional | AS · PA/NP assist | $12.88 | $15.49 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $47.86 Typical High $104.71 | Professional | 52 · Reduced service | $47.86 | $47.86 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $41.69 | Professional | 53 · Discontinued | $19.05 | $19.05 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $158.49 | Professional | 54 · Surgery only | $72.44 | $72.44 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $31.62 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $20.89 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $162.18 | Professional | 54 · Surgery only | $74.13 | $74.13 | $162.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $23.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $173.78 |
Where Idaho sits
The same service costs 3.2 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· 17th of 51
$129
AK $275KY $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.