How much rates vary
Facilitymedian $437 · 10th to 90th $155 to $1,380Professionalmedian $1,000 · 10th to 90th $692 to $1,445
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 $616.60 Median $1,000.00 Typical High $1,380.38 | Professional | None | $616.60 | $1,000.00 | $1,380.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $501.19 Typical High $1,202.26 | Facility | None | $173.78 | $501.19 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $776.25 | $1,096.48 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $218.78 | Facility | None | $141.25 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,071.52 | Professional | None | $691.83 | $831.76 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $4,466.84 | Facility | None | $616.60 | $1,000.00 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,380.38 | Professional | None | $707.95 | $1,174.90 | $1,380.38 |
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 $851.14 Median $851.14 Typical High $1,380.38 | Facility | None | $851.14 | $851.14 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,737.80 | Professional | None | $851.14 | $1,096.48 | $1,737.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $794.33 | Facility | None | $407.38 | $588.84 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,621.81 | Professional | None | $954.99 | $1,174.90 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $1,148.15 | Facility | None | $660.69 | $676.08 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $660.69 Typical High $891.25 | Professional | None | $144.54 | $660.69 | $891.25 |
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 $575.44 Median $933.25 Typical High $1,412.54 | Professional | None | $575.44 | $933.25 | $1,412.54 |
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 $309.03 Median $501.19 Typical High $691.83 | Professional | 52 · Reduced service | $309.03 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $123.03 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $758.58 Typical High $1,047.13 | Professional | 54 · Surgery only | $457.09 | $758.58 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $100.00 Typical High $138.04 | Professional | 56 · Pre-op care only | $61.66 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $426.58 | $707.95 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,148.15 Typical High $1,412.54 | Professional | 54 · Surgery only | $707.95 | $1,148.15 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $77.62 | $123.03 | $151.36 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,047.13 Median $1,288.25 Typical High $1,819.70 | Professional | 63 · Small infant | $1,047.13 | $1,288.25 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $125.89 | $173.78 | $234.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $147.91 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $125.89 | $147.91 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $151.36 | $229.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $169.82 Typical High $204.17 | Professional | AS · PA/NP assist | $109.65 | $169.82 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $501.19 Typical High $691.83 | Professional | 52 · Reduced service | $309.03 | $501.19 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $123.03 | $204.17 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $758.58 Typical High $1,047.13 | Professional | 54 · Surgery only | $457.09 | $758.58 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $100.00 Typical High $138.04 | Professional | 56 · Pre-op care only | $61.66 | $100.00 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $426.58 | $707.95 | $977.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | 54 · Surgery only | $758.58 | $758.58 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $151.36 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,148.15 |
Where Idaho sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 9th of 51
$1,000
AK $1,950MD $537
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.