How much rates vary
Facilitymedian $234 · 10th to 90th $44 to $794Professionalmedian $55 · 10th to 90th $41 to $115
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $91.20 | Professional | None | $43.65 | $60.26 | $91.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $87.10 Median $269.15 Typical High $794.33 | Facility | None | $87.10 | $269.15 | $794.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $134.90 | Professional | None | $43.65 | $52.48 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $93.33 | Professional | None | $39.81 | $52.48 | $93.33 |
Moda Health Setting Facility Modifier None Typical Low $22.39 Median $81.28 Typical High $5,495.41 | Facility | None | $22.39 | $81.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $114.82 | Professional | None | $39.81 | $81.28 | $114.82 |
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 $38.02 Median $40.74 Typical High $109.65 | Facility | None | $38.02 | $40.74 | $109.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $128.82 | Professional | None | $40.74 | $47.86 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $114.82 | Professional | None | $43.65 | $61.66 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $602.56 | Facility | None | $60.26 | $61.66 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | None | $60.26 | $60.26 | $77.62 |
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 $32.36 Median $54.95 Typical High $100.00 | Professional | None | $32.36 | $54.95 | $100.00 |
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 $21.88 Median $28.84 Typical High $44.67 | Professional | 52 · Reduced service | $21.88 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.48 Typical High $18.20 | Professional | 53 · Discontinued | $8.91 | $11.48 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $43.65 Typical High $67.61 | Professional | 54 · Surgery only | $33.11 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.71 Typical High $13.49 | Professional | 55 · Aftercare only | $6.61 | $8.71 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $9.12 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $47.86 Typical High $117.49 | Professional | 54 · Surgery only | $38.90 | $47.86 | $117.49 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $10.23 Typical High $13.80 | Professional | 55 · Aftercare only | $4.90 | $10.23 | $13.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $52.48 Median $123.03 Typical High $158.49 | Professional | 63 · Small infant | $52.48 | $123.03 | $158.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $36.31 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $30.20 | $36.31 | $87.10 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.92 Median $8.13 Typical High $18.20 | Professional | 80 · Assistant surgeon | $6.92 | $8.13 | $18.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $15.49 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $7.76 | $15.49 | $22.91 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.92 Median $8.13 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $6.92 | $8.13 | $19.95 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $5.89 Median $6.92 Typical High $16.98 | Professional | AS · PA/NP assist | $5.89 | $6.92 | $16.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $44.67 | Professional | 52 · Reduced service | $21.88 | $21.88 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $18.20 | Professional | 53 · Discontinued | $8.91 | $8.91 | $18.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $67.61 | Professional | 54 · Surgery only | $33.11 | $33.11 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $13.49 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $9.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $72.44 | Professional | 54 · Surgery only | $33.88 | $33.88 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $10.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $36.31 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $36.31 | $36.31 | $77.62 |
Where Idaho sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 12th of 51
$67.61
AK $148TX $37.15
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.