How much rates vary
Facilitymedian $174 · 10th to 90th $68 to $603Professionalmedian $98 · 10th to 90th $72 to $155
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 $77.62 Median $77.62 Typical High $120.23 | Professional | None | $77.62 | $77.62 | $120.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $269.15 Typical High $602.56 | Facility | None | $67.61 | $269.15 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $186.21 | Professional | None | $79.43 | $107.15 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $93.33 | Facility | None | $61.66 | $69.18 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $123.03 | Professional | None | $69.18 | $87.10 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $104.71 Typical High $4,466.84 | Facility | None | $56.23 | $104.71 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $154.88 | Professional | None | $74.13 | $100.00 | $154.88 |
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 $69.18 Median $74.13 Typical High $144.54 | Facility | None | $69.18 | $74.13 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $169.82 | Professional | None | $74.13 | $102.33 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $512.86 Typical High $660.69 | Facility | None | $346.74 | $512.86 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $154.88 | Professional | None | $79.43 | $102.33 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $616.60 | Facility | None | $81.28 | $83.18 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | None | $81.28 | $81.28 | $104.71 |
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 $54.95 Median $83.18 Typical High $125.89 | Professional | None | $54.95 | $83.18 | $125.89 |
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 $38.90 Median $38.90 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $15.85 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $91.20 | Professional | 54 · Surgery only | $58.88 | $58.88 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $18.20 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $12.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $79.43 Typical High $131.83 | Professional | 54 · Surgery only | $70.79 | $79.43 | $131.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.30 Typical High $18.62 | Professional | 55 · Aftercare only | $8.13 | $12.30 | $18.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $93.33 Median $114.82 Typical High $223.87 | Professional | 63 · Small infant | $93.33 | $114.82 | $223.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $64.57 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $54.95 | $64.57 | $125.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.59 Median $14.79 Typical High $30.20 | Professional | 80 · Assistant surgeon | $12.59 | $14.79 | $30.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $24.55 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $13.80 | $24.55 | $29.51 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.59 Median $13.80 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $12.59 | $13.80 | $30.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $12.02 Typical High $20.42 | Professional | AS · PA/NP assist | $10.72 | $12.02 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $38.90 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $38.90 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $15.85 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $91.20 | Professional | 54 · Surgery only | $58.88 | $58.88 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $18.20 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $12.02 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $95.50 | Professional | 54 · Surgery only | $60.26 | $60.26 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $13.80 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $64.57 | $64.57 | $102.33 |
Where Idaho sits
The same service costs 3.4 times more in Alaska than in New York. 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
$100
AK $209NY $61.66
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.