How much rates vary
Facilitymedian $347 · 10th to 90th $98 to $1,820Professionalmedian $174 · 10th to 90th $129 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 $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 $109.65 Median $141.25 Typical High $218.78 | Professional | None | $109.65 | $141.25 | $218.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $389.05 Typical High $1,819.70 | Facility | None | $102.33 | $389.05 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $309.03 | Professional | None | $141.25 | $190.55 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $131.83 | Facility | None | $87.10 | $97.72 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $229.09 | Professional | None | $125.89 | $162.18 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $5,495.41 | Facility | None | $112.20 | $190.55 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $275.42 | Professional | None | $131.83 | $177.83 | $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 $125.89 Median $131.83 Typical High $239.88 | Facility | None | $125.89 | $131.83 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $281.84 | Professional | None | $131.83 | $169.82 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,737.80 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $275.42 | Professional | None | $141.25 | $177.83 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $891.25 | Facility | None | $134.90 | $138.04 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $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 $70.79 Median $70.79 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $70.79 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | 53 · Discontinued | $28.18 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $107.15 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $21.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $154.88 | $275.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $14.79 | $21.88 | $31.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $295.12 Typical High $331.13 | Professional | 63 · Small infant | $190.55 | $295.12 | $331.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $213.80 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $34.67 Typical High $51.29 | Professional | 80 · Assistant surgeon | $23.44 | $34.67 | $51.29 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $41.69 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $25.12 | $41.69 | $48.98 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $41.69 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $41.69 | $48.98 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $22.39 Typical High $39.81 | Professional | AS · PA/NP assist | $19.50 | $22.39 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $70.79 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | 53 · Discontinued | $28.18 | $28.18 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $107.15 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $169.82 | Professional | 54 · Surgery only | $109.65 | $109.65 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $181.97 |
Where Idaho sits
The same service costs 3.2 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· 14th of 51
$178
AK $372FL $117
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.