How much rates vary
Facilitymedian $170 · 10th to 90th $115 to $1,047Professionalmedian $145 · 10th to 90th $102 to $295
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 $75.86 Median $114.82 Typical High $239.88 | Professional | None | $75.86 | $114.82 | $239.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $1,047.13 | Facility | None | $112.20 | $144.54 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $316.23 | Professional | None | $112.20 | $204.17 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $128.82 Typical High $173.78 | Facility | None | $114.82 | $128.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $251.19 | Professional | None | $104.71 | $141.25 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $141.25 Typical High $4,466.84 | Facility | None | $79.43 | $141.25 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $302.00 | Professional | None | $100.00 | $144.54 | $302.00 |
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 $97.72 Median $102.33 Typical High $251.19 | Facility | None | $97.72 | $102.33 | $251.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $295.12 | Professional | None | $102.33 | $173.78 | $295.12 |
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 $112.20 Median $154.88 Typical High $302.00 | Professional | None | $112.20 | $154.88 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $295.12 | Facility | None | $141.25 | $141.25 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
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 $81.28 Median $131.83 Typical High $239.88 | Professional | None | $81.28 | $131.83 | $239.88 |
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 $56.23 Median $74.13 Typical High $120.23 | Professional | 52 · Reduced service | $56.23 | $74.13 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $47.86 | Professional | 53 · Discontinued | $22.91 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $112.20 Typical High $177.83 | Professional | 54 · Surgery only | $85.11 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $35.48 | Professional | 55 · Aftercare only | $16.98 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $23.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $117.49 Typical High $275.42 | Professional | 54 · Surgery only | $100.00 | $117.49 | $275.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $12.88 | $26.30 | $30.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $128.82 Median $162.18 Typical High $363.08 | Professional | 63 · Small infant | $128.82 | $162.18 | $363.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $165.96 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $77.62 | $165.96 | $229.09 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.78 Median $20.89 Typical High $48.98 | Professional | 80 · Assistant surgeon | $17.78 | $20.89 | $48.98 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $20.89 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $17.78 | $20.89 | $43.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $20.89 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $20.89 | $52.48 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $15.49 Median $17.38 Typical High $37.15 | Professional | AS · PA/NP assist | $15.49 | $17.38 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $56.23 Typical High $120.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $47.86 | Professional | 53 · Discontinued | $22.91 | $22.91 | $47.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $177.83 | Professional | 54 · Surgery only | $85.11 | $85.11 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $35.48 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $23.99 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $186.21 | Professional | 54 · Surgery only | $89.13 | $89.13 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $26.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $199.53 |
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
$145
AK $309KY $97.72
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.