How much rates vary
Facilitymedian $525 · 10th to 90th $178 to $1,905Professionalmedian $417 · 10th to 90th $302 to $631
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 $309.03 Median $316.23 Typical High $501.19 | Professional | None | $309.03 | $316.23 | $501.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $660.69 Typical High $1,905.46 | Facility | None | $112.20 | $660.69 | $1,905.46 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $691.83 | Professional | None | $323.59 | $436.52 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $562.34 | Professional | None | $302.00 | $398.11 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $4,466.84 | Facility | None | $177.83 | $309.03 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $630.96 | Professional | None | $309.03 | $426.58 | $630.96 |
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 $302.00 Median $323.59 Typical High $549.54 | Facility | None | $302.00 | $323.59 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | None | $323.59 | $380.19 | $645.65 |
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 $323.59 Median $416.87 Typical High $630.96 | Professional | None | $323.59 | $416.87 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $371.54 | Facility | None | $302.00 | $302.00 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
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 $251.19 Median $416.87 Typical High $645.65 | Professional | None | $251.19 | $416.87 | $645.65 |
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 $154.88 Median $158.49 Typical High $251.19 | Professional | 52 · Reduced service | $154.88 | $158.49 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $100.00 | Professional | 53 · Discontinued | $63.10 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $75.86 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $354.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $630.96 | Professional | 54 · Surgery only | $309.03 | $354.81 | $630.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $69.18 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $69.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $416.87 Median $676.08 Typical High $812.83 | Professional | 63 · Small infant | $416.87 | $676.08 | $812.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $389.05 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $91.20 Typical High $114.82 | Professional | 80 · Assistant surgeon | $54.95 | $91.20 | $114.82 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $91.20 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $54.95 | $91.20 | $112.20 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $64.57 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $64.57 | $95.50 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $53.70 Typical High $95.50 | Professional | AS · PA/NP assist | $48.98 | $53.70 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $158.49 Typical High $251.19 | Professional | 52 · Reduced service | $154.88 | $158.49 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $100.00 | Professional | 53 · Discontinued | $63.10 | $63.10 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $234.42 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $75.86 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $251.19 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $426.58 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$417
AK $933KY $229
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.