How much rates vary
Facilitymedian $324 · 10th to 90th $170 to $692Professionalmedian $380 · 10th to 90th $245 to $661
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 $229.09 Median $363.08 Typical High $575.44 | Professional | None | $229.09 | $363.08 | $575.44 |
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 $302.00 Median $416.87 Typical High $707.95 | Professional | None | $302.00 | $416.87 | $707.95 |
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 $239.88 Median $309.03 Typical High $446.68 | Professional | None | $239.88 | $309.03 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $380.19 Typical High $4,466.84 | Facility | None | $181.97 | $380.19 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $645.65 | Professional | None | $281.84 | $426.58 | $645.65 |
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 $323.59 Median $323.59 Typical High $645.65 | Facility | None | $323.59 | $323.59 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $812.83 | Professional | None | $323.59 | $407.38 | $812.83 |
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 $363.08 Median $426.58 Typical High $707.95 | Professional | None | $363.08 | $426.58 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $549.54 | Facility | None | $309.03 | $316.23 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $389.05 | Professional | None | $173.78 | $275.42 | $389.05 |
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 $194.98 Median $309.03 Typical High $549.54 | Professional | None | $194.98 | $309.03 | $549.54 |
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 $114.82 Median $181.97 Typical High $288.40 | Professional | 52 · Reduced service | $114.82 | $181.97 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $117.49 | Professional | 53 · Discontinued | $45.71 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $269.15 Typical High $436.52 | Professional | 54 · Surgery only | $169.82 | $269.15 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $53.70 Typical High $87.10 | Professional | 55 · Aftercare only | $34.67 | $53.70 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $57.54 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $57.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $602.56 | Professional | 54 · Surgery only | $281.84 | $331.13 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $70.79 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $70.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $426.58 Typical High $831.76 | Professional | 63 · Small infant | $363.08 | $426.58 | $831.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $467.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $56.23 Typical High $112.20 | Professional | 80 · Assistant surgeon | $47.86 | $56.23 | $112.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $87.10 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $47.86 | $87.10 | $117.49 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $85.11 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $85.11 | $112.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $50.12 Typical High $95.50 | Professional | AS · PA/NP assist | $40.74 | $50.12 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $181.97 Typical High $288.40 | Professional | 52 · Reduced service | $114.82 | $181.97 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $117.49 | Professional | 53 · Discontinued | $45.71 | $72.44 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $269.15 Typical High $436.52 | Professional | 54 · Surgery only | $169.82 | $269.15 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $53.70 Typical High $87.10 | Professional | 55 · Aftercare only | $34.67 | $53.70 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $57.54 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $57.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $467.74 | Professional | 54 · Surgery only | $275.42 | $275.42 | $467.74 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $66.07 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $501.19 |
Where Idaho sits
The same service costs 4.0 times more in Alaska 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· 11th of 51
$380
AK $741KY $186
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.