How much rates vary
Facilitymedian $479 · 10th to 90th $126 to $1,660Professionalmedian $117 · 10th to 90th $47 to $132
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 $100.00 Median $117.49 Typical High $117.49 | Professional | None | $100.00 | $117.49 | $117.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $457.09 Typical High $1,621.81 | Facility | None | $112.20 | $457.09 | $1,621.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $120.23 | Professional | None | $40.74 | $48.98 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $676.08 | Facility | None | $446.68 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $120.23 | Professional | None | $93.33 | $107.15 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $5,495.41 | Facility | None | $85.11 | $117.49 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | None | $125.89 | $125.89 | $147.91 |
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 $102.33 Median $120.23 Typical High $123.03 | Professional | None | $102.33 | $120.23 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,479.11 | Facility | None | $512.86 | $707.95 | $1,479.11 |
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 $75.86 Median $100.00 Typical High $138.04 | Professional | None | $75.86 | $100.00 | $138.04 |
18 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 $53.70 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $53.70 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $21.38 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $11.75 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $42.66 Typical High $45.71 | Professional | 54 · Surgery only | $37.15 | $42.66 | $45.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.68 Typical High $5.13 | Professional | 55 · Aftercare only | $4.07 | $4.68 | $5.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $48.98 Median $56.23 Typical High $61.66 | Professional | 63 · Small infant | $48.98 | $56.23 | $61.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $33.11 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $28.84 | $33.11 | $35.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $7.59 Typical High $8.13 | Professional | 80 · Assistant surgeon | $6.61 | $7.59 | $8.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.61 Median $7.59 Typical High $8.13 | Professional | 81 · Minimal assistant surgeon | $6.61 | $7.59 | $8.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.61 Median $7.59 Typical High $8.13 | Professional | 82 · Assistant surgeon, no resident | $6.61 | $7.59 | $8.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $5.62 Median $6.31 Typical High $6.92 | Professional | AS · PA/NP assist | $5.62 | $6.31 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $53.70 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $21.38 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $81.28 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $11.75 |
Where Idaho sits
The same service costs 5.5 times more in Arkansas 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· 19th of 51
$120
AR $331KY $60.26
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.