How much rates vary
Facilitymedian $170 · 10th to 90th $93 to $692Professionalmedian $141 · 10th to 90th $93 to $224
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 $89.13 Median $141.25 Typical High $199.53 | Professional | None | $89.13 | $141.25 | $199.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $812.83 | Facility | None | $93.33 | $177.83 | $812.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $239.88 | Professional | None | $117.49 | $165.96 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $131.83 | Facility | None | $87.10 | $97.72 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $151.36 | Professional | None | $93.33 | $107.15 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $141.25 Typical High $4,466.84 | Facility | None | $64.57 | $141.25 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $218.78 | Professional | None | $109.65 | $165.96 | $218.78 |
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 $128.82 Median $128.82 Typical High $218.78 | Facility | None | $128.82 | $128.82 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $275.42 | Professional | None | $128.82 | $162.18 | $275.42 |
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 $141.25 Median $165.96 Typical High $239.88 | Professional | None | $141.25 | $165.96 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $316.23 | Facility | None | $104.71 | $107.15 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $131.83 | Professional | None | $70.79 | $104.71 | $131.83 |
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 $75.86 Median $112.20 Typical High $186.21 | Professional | None | $75.86 | $112.20 | $186.21 |
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 $43.65 Median $69.18 Typical High $100.00 | Professional | 52 · Reduced service | $43.65 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $28.18 Typical High $39.81 | Professional | 53 · Discontinued | $17.78 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $104.71 Typical High $147.91 | Professional | 54 · Surgery only | $66.07 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $20.89 Typical High $29.51 | Professional | 55 · Aftercare only | $13.18 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.13 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.91 | $14.13 | $19.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $138.04 Typical High $213.80 | Professional | 54 · Surgery only | $107.15 | $138.04 | $213.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $23.44 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $23.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $141.25 Median $165.96 Typical High $288.40 | Professional | 63 · Small infant | $141.25 | $165.96 | $288.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $97.72 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $83.18 | $97.72 | $138.04 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $24.55 Typical High $37.15 | Professional | 80 · Assistant surgeon | $19.05 | $24.55 | $37.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $22.91 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $19.05 | $22.91 | $37.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $24.55 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $24.55 | $38.90 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $19.50 Typical High $31.62 | Professional | AS · PA/NP assist | $16.22 | $19.50 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $69.18 Typical High $100.00 | Professional | 52 · Reduced service | $43.65 | $69.18 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $28.18 Typical High $39.81 | Professional | 53 · Discontinued | $17.78 | $28.18 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $104.71 Typical High $147.91 | Professional | 54 · Surgery only | $66.07 | $104.71 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $20.89 Typical High $29.51 | Professional | 55 · Aftercare only | $13.18 | $20.89 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.13 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.91 | $14.13 | $19.95 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $154.88 | Professional | 54 · Surgery only | $107.15 | $107.15 | $154.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $22.39 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $165.96 |
Where Idaho sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 10th of 51
$141
AK $282FL $74.13
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.