How much rates vary
Facilitymedian $219 · 10th to 90th $110 to $1,622Professionalmedian $186 · 10th to 90th $141 to $275
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 $154.88 Median $154.88 Typical High $218.78 | Professional | None | $154.88 | $154.88 | $218.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $275.42 Typical High $1,659.59 | Facility | None | $109.65 | $275.42 | $1,659.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $331.13 | Professional | None | $154.88 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $112.20 Typical High $154.88 | Facility | None | $100.00 | $112.20 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $223.87 | Professional | None | $128.82 | $162.18 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $186.21 Typical High $4,466.84 | Facility | None | $109.65 | $186.21 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $275.42 | Professional | None | $144.54 | $194.98 | $275.42 |
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 $138.04 Median $144.54 Typical High $257.04 | Facility | None | $138.04 | $144.54 | $257.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $302.00 | Professional | None | $144.54 | $181.97 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $275.42 | Professional | None | $154.88 | $194.98 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $707.95 | Facility | None | $144.54 | $147.91 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | None | $144.54 | $144.54 | $186.21 |
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 $112.20 Median $158.49 Typical High $239.88 | Professional | None | $112.20 | $158.49 | $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 $77.62 Median $77.62 Typical High $107.15 | Professional | 52 · Reduced service | $77.62 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $30.90 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 54 · Surgery only | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $21.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $295.12 | Professional | 54 · Surgery only | $141.25 | $158.49 | $295.12 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $28.18 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $28.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $186.21 Median $316.23 Typical High $398.11 | Professional | 63 · Small infant | $186.21 | $316.23 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $199.53 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $27.54 Typical High $53.70 | Professional | 80 · Assistant surgeon | $25.12 | $27.54 | $53.70 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.70 Median $44.67 Typical High $53.70 | Professional | 81 · Minimal assistant surgeon | $25.70 | $44.67 | $53.70 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $30.20 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $30.20 | $51.29 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $33.11 Typical High $45.71 | Professional | AS · PA/NP assist | $20.89 | $33.11 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | 52 · Reduced service | $77.62 | $77.62 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $30.90 | $30.90 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 54 · Surgery only | $117.49 | $117.49 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $169.82 | Professional | 54 · Surgery only | $120.23 | $120.23 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $181.97 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 11th of 51
$191
AK $407FL $110
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.