How much rates vary
Facilitymedian $537 · 10th to 90th $355 to $5,888Professionalmedian $708 · 10th to 90th $525 to $933
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 $562.34 Median $562.34 Typical High $741.31 | Professional | None | $562.34 | $562.34 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $7,413.10 | Facility | None | $323.59 | $794.33 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,000.00 | Professional | None | $575.44 | $707.95 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $537.03 | Facility | None | $346.74 | $389.05 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $812.83 | Professional | None | $467.74 | $588.84 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $691.83 Typical High $4,466.84 | Facility | None | $302.00 | $691.83 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $933.25 | Professional | None | $524.81 | $707.95 | $933.25 |
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 $512.86 Median $537.03 Typical High $794.33 | Facility | None | $512.86 | $537.03 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $933.25 | Professional | None | $537.03 | $630.96 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $933.25 | Professional | None | $575.44 | $707.95 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $2,238.72 | Facility | None | $446.68 | $446.68 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
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 $426.58 Median $645.65 Typical High $933.25 | Professional | None | $426.58 | $645.65 | $933.25 |
23 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 $281.84 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $512.86 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $741.31 | $933.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $104.71 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $104.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $776.25 Typical High $1,148.15 | Professional | 63 · Small infant | $676.08 | $776.25 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $575.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $398.11 | $575.44 | $724.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $141.25 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $141.25 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $120.23 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $93.33 | $120.23 | $162.18 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $107.15 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $107.15 | $165.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $117.49 Typical High $141.25 | Professional | AS · PA/NP assist | $89.13 | $117.49 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $281.84 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $112.20 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $416.87 | $549.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $512.86 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $446.68 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $616.60 |
Where Idaho sits
The same service costs 5.1 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· 11th of 51
$676
AK $1,514TX $295
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.