How much rates vary
Facilitymedian $468 · 10th to 90th $112 to $1,202Professionalmedian $646 · 10th to 90th $479 to $891
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 $457.09 Median $537.03 Typical High $724.44 | Professional | None | $457.09 | $537.03 | $724.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $501.19 Typical High $1,202.26 | Facility | None | $66.07 | $501.19 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $977.24 | Professional | None | $549.54 | $691.83 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $741.31 | Professional | None | $436.52 | $549.54 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $537.03 Typical High $4,466.84 | Facility | None | $295.12 | $537.03 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $912.01 | Professional | None | $524.81 | $676.08 | $912.01 |
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 $501.19 Median $537.03 Typical High $776.25 | Facility | None | $501.19 | $537.03 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $912.01 | Professional | None | $537.03 | $630.96 | $912.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $912.01 | Professional | None | $549.54 | $676.08 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $436.52 Typical High $446.68 | Facility | None | $162.18 | $436.52 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $602.56 | Professional | None | $436.52 | $436.52 | $602.56 |
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 $380.19 Median $537.03 Typical High $812.83 | Professional | None | $380.19 | $537.03 | $812.83 |
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 $269.15 Median $269.15 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 53 · Discontinued | $107.15 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $501.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $933.25 | Professional | 54 · Surgery only | $512.86 | $602.56 | $933.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $95.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $870.96 Typical High $1,047.13 | Professional | 63 · Small infant | $776.25 | $870.96 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $426.58 | $575.44 | $691.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $165.96 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $165.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $112.20 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $91.20 | $112.20 | $158.49 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $114.82 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $114.82 | $165.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $95.50 Typical High $134.90 | Professional | AS · PA/NP assist | $77.62 | $95.50 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $269.15 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 53 · Discontinued | $107.15 | $107.15 | $144.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $398.11 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $72.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $501.19 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $426.58 | $562.34 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $602.56 |
Where Idaho sits
The same service costs 4.7 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· 10th of 51
$631
AK $1,445TX $309
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.