How much rates vary
Facilitymedian $302 · 10th to 90th $162 to $1,380Professionalmedian $257 · 10th to 90th $178 to $324
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 $162.18 Median $263.03 Typical High $309.03 | Professional | None | $162.18 | $263.03 | $309.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $501.19 Typical High $1,445.44 | Facility | None | $199.53 | $501.19 | $1,445.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $331.13 | Professional | None | $218.78 | $269.15 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $257.04 | Facility | None | $169.82 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $234.42 | Professional | None | $162.18 | $199.53 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $309.03 Typical High $5,495.41 | Facility | None | $144.54 | $309.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $309.03 | Professional | None | $194.98 | $263.03 | $309.03 |
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 $234.42 Median $234.42 Typical High $302.00 | Facility | None | $234.42 | $234.42 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $380.19 | Professional | None | $234.42 | $295.12 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $870.96 | Facility | None | $467.74 | $676.08 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $363.08 | Professional | None | $257.04 | $302.00 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $2,398.83 | Facility | None | $144.54 | $147.91 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $199.53 | Professional | None | $128.82 | $144.54 | $199.53 |
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 $141.25 Median $199.53 Typical High $302.00 | Professional | None | $141.25 | $199.53 | $302.00 |
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 $79.43 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $79.43 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $32.36 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $120.23 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $23.99 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.22 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $112.20 | $181.97 | $218.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $194.98 | $251.19 | $295.12 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $21.88 | $28.18 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $269.15 Median $316.23 Typical High $398.11 | Professional | 63 · Small infant | $269.15 | $316.23 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $229.09 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 80 · Assistant surgeon | $34.67 | $42.66 | $52.48 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $42.66 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $34.67 | $42.66 | $50.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $50.12 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $50.12 | $54.95 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $36.31 Typical High $46.77 | Professional | AS · PA/NP assist | $29.51 | $36.31 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $79.43 | $131.83 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $32.36 | $52.48 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $120.23 | $194.98 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $23.99 | $38.90 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.22 | $26.30 | $30.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $112.20 | $181.97 | $218.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $199.53 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $257.04 |
Where Idaho sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 8th of 51
$257
AK $513DE $135
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.