How much rates vary
Facilitymedian $302 · 10th to 90th $170 to $759Professionalmedian $324 · 10th to 90th $214 to $562
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 $199.53 Median $316.23 Typical High $489.78 | Professional | None | $199.53 | $316.23 | $489.78 |
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 $346.74 Typical High $588.84 | Professional | None | $269.15 | $346.74 | $588.84 |
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 $208.93 Median $263.03 Typical High $380.19 | Professional | None | $208.93 | $263.03 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $446.68 Typical High $5,495.41 | Facility | None | $169.82 | $446.68 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $537.03 | Professional | None | $251.19 | $371.54 | $537.03 |
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 $288.40 Median $288.40 Typical High $549.54 | Facility | None | $288.40 | $288.40 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $691.83 | Professional | None | $288.40 | $363.08 | $691.83 |
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 $316.23 Median $371.54 Typical High $588.84 | Professional | None | $316.23 | $371.54 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $549.54 | Facility | None | $263.03 | $263.03 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $323.59 | Professional | None | $158.49 | $245.47 | $323.59 |
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 $269.15 Typical High $467.74 | Professional | None | $173.78 | $269.15 | $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 $100.00 Median $158.49 Typical High $245.47 | Professional | 52 · Reduced service | $100.00 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $97.72 | Professional | 53 · Discontinued | $40.74 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $234.42 Typical High $371.54 | Professional | 54 · Surgery only | $151.36 | $234.42 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $74.13 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $48.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $239.88 | $407.38 | $537.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $45.71 Typical High $58.88 | Professional | 55 · Aftercare only | $26.92 | $45.71 | $58.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $416.87 Typical High $707.95 | Professional | 63 · Small infant | $323.59 | $416.87 | $707.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $194.98 | $346.74 | $416.87 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $72.44 Typical High $95.50 | Professional | 80 · Assistant surgeon | $42.66 | $72.44 | $95.50 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $72.44 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $42.66 | $72.44 | $97.72 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $50.12 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $50.12 | $93.33 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $46.77 Typical High $81.28 | Professional | AS · PA/NP assist | $36.31 | $46.77 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $158.49 Typical High $245.47 | Professional | 52 · Reduced service | $100.00 | $158.49 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $97.72 | Professional | 53 · Discontinued | $40.74 | $63.10 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $234.42 Typical High $371.54 | Professional | 54 · Surgery only | $151.36 | $234.42 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $74.13 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $48.98 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $245.47 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $416.87 |
Where Idaho sits
The same service costs 3.9 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
$324
AK $692MD $178
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.