How much rates vary
Facilitymedian $380 · 10th to 90th $135 to $646Professionalmedian $123 · 10th to 90th $72 to $447
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $169.82 Typical High $446.68 | Professional | None | $64.57 | $169.82 | $446.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $602.56 | Facility | None | $295.12 | $446.68 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $309.03 Typical High $436.52 | Professional | None | $81.28 | $309.03 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $173.78 Typical High $338.84 | Professional | None | $72.44 | $173.78 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $302.00 Typical High $5,495.41 | Facility | None | $64.57 | $302.00 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $223.87 Typical High $446.68 | Professional | None | $72.44 | $223.87 | $446.68 |
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 $85.11 Median $85.11 Typical High $398.11 | Facility | None | $85.11 | $85.11 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $501.19 | Professional | None | $85.11 | $112.20 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $512.86 | Professional | None | $102.33 | $141.25 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $380.19 | Facility | None | $190.55 | $194.98 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $190.55 Typical High $257.04 | Professional | None | $51.29 | $190.55 | $257.04 |
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 $57.54 Median $162.18 Typical High $346.74 | Professional | None | $57.54 | $162.18 | $346.74 |
24 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 $32.36 Median $79.43 Typical High $223.87 | Professional | 52 · Reduced service | $32.36 | $79.43 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $31.62 Typical High $91.20 | Professional | 53 · Discontinued | $12.88 | $31.62 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $120.23 Typical High $338.84 | Professional | 54 · Surgery only | $48.98 | $120.23 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $23.99 Typical High $67.61 | Professional | 55 · Aftercare only | $9.77 | $23.99 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $15.85 Typical High $44.67 | Professional | 56 · Pre-op care only | $6.46 | $15.85 | $44.67 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $457.09 Median $691.83 Typical High $891.25 | Facility | 50 · Both sides | $457.09 | $691.83 | $891.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $169.82 Typical High $645.65 | Professional | 50 · Both sides | $123.03 | $169.82 | $645.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $72.44 | $331.13 | $389.05 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.55 Typical High $42.66 | Professional | 55 · Aftercare only | $7.94 | $9.55 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $104.71 Median $446.68 Typical High $524.81 | Professional | 63 · Small infant | $104.71 | $446.68 | $524.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $54.95 | $251.19 | $302.00 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.59 Median $14.79 Typical High $72.44 | Professional | 80 · Assistant surgeon | $12.59 | $14.79 | $72.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.59 Median $15.14 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $12.59 | $15.14 | $69.18 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.88 Median $57.54 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $12.88 | $57.54 | $72.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $12.88 Typical High $58.88 | Professional | AS · PA/NP assist | $10.72 | $12.88 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $52.48 Typical High $223.87 | Professional | 52 · Reduced service | $32.36 | $52.48 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $21.38 Typical High $91.20 | Professional | 53 · Discontinued | $12.88 | $21.38 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $79.43 Typical High $338.84 | Professional | 54 · Surgery only | $48.98 | $79.43 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.85 Typical High $67.61 | Professional | 55 · Aftercare only | $9.77 | $15.85 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.47 Typical High $44.67 | Professional | 56 · Pre-op care only | $6.46 | $10.47 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $169.82 Typical High $691.83 | Professional | 50 · Both sides | $169.82 | $169.82 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $323.59 | Professional | 54 · Surgery only | $79.43 | $79.43 | $323.59 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $45.71 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $45.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $346.74 |
Where Idaho sits
The same service costs 4.6 times more in Iowa 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· 17th of 51
$186
IA $288KY $63.10
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.