How much rates vary
Facilitymedian $295 · 10th to 90th $170 to $692Professionalmedian $355 · 10th to 90th $219 to $617
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 $204.17 Median $323.59 Typical High $537.03 | Professional | None | $204.17 | $323.59 | $537.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $691.83 | Facility | None | $186.21 | $331.13 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $660.69 | Professional | None | $269.15 | $416.87 | $660.69 |
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 $213.80 Median $269.15 Typical High $416.87 | Professional | None | $213.80 | $269.15 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $4,466.84 | Facility | None | $177.83 | $354.81 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $602.56 | Professional | None | $251.19 | $380.19 | $602.56 |
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 $295.12 Median $295.12 Typical High $616.60 | Facility | None | $295.12 | $295.12 | $616.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $776.25 | Professional | None | $295.12 | $371.54 | $776.25 |
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 $323.59 Median $380.19 Typical High $660.69 | Professional | None | $323.59 | $380.19 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $549.54 | Facility | None | $288.40 | $295.12 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $363.08 | Professional | None | $162.18 | $245.47 | $363.08 |
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 $173.78 Median $288.40 Typical High $467.74 | Professional | None | $173.78 | $288.40 | $467.74 |
21 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 $102.33 Median $158.49 Typical High $269.15 | Professional | 52 · Reduced service | $102.33 | $158.49 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $107.15 | Professional | 53 · Discontinued | $40.74 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $407.38 | Professional | 54 · Surgery only | $151.36 | $239.88 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $81.28 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $53.70 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $53.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $288.40 | $562.34 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.11 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $33.11 | $63.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $676.08 Typical High $794.33 | Professional | 63 · Small infant | $363.08 | $676.08 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $467.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $83.18 Typical High $107.15 | Professional | 80 · Assistant surgeon | $43.65 | $83.18 | $107.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $43.65 Median $52.48 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $43.65 | $52.48 | $107.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $43.65 Median $52.48 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $43.65 | $52.48 | $107.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $69.18 Typical High $89.13 | Professional | AS · PA/NP assist | $37.15 | $69.18 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $158.49 Typical High $269.15 | Professional | 52 · Reduced service | $102.33 | $158.49 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $107.15 | Professional | 53 · Discontinued | $40.74 | $64.57 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $407.38 | Professional | 54 · Surgery only | $151.36 | $239.88 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $81.28 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $53.70 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $245.47 | $436.52 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $61.66 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $467.74 |
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· 12th of 51
$339
AK $661MD $182
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.