How much rates vary
Facilitymedian $174 · 10th to 90th $33 to $407Professionalmedian $46 · 10th to 90th $27 to $74
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 Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $72.44 | Professional | None | $22.91 | $39.81 | $72.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $186.21 Typical High $389.05 | Facility | None | $66.07 | $186.21 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $30.20 Median $52.48 Typical High $74.13 | Professional | None | $30.20 | $52.48 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $57.54 | Professional | None | $26.92 | $39.81 | $57.54 |
Moda Health Setting Facility Modifier None Typical Low $22.91 Median $44.67 Typical High $72.44 | Facility | None | $22.91 | $44.67 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $45.71 Typical High $72.44 | Professional | None | $25.12 | $45.71 | $72.44 |
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 $31.62 Median $31.62 Typical High $69.18 | Facility | None | $31.62 | $31.62 | $69.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $87.10 | Professional | None | $31.62 | $41.69 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $416.87 | Facility | None | $218.78 | $309.03 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $85.11 | Professional | None | $36.31 | $45.71 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $120.23 | Facility | None | $33.11 | $33.11 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $19.05 Median $33.11 Typical High $44.67 | Professional | None | $19.05 | $33.11 | $44.67 |
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 $20.89 Median $47.86 Typical High $79.43 | Professional | None | $20.89 | $47.86 | $79.43 |
22 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 $11.48 Median $19.50 Typical High $36.31 | Professional | 52 · Reduced service | $11.48 | $19.50 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $7.94 Typical High $14.45 | Professional | 53 · Discontinued | $4.57 | $7.94 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $5.89 Typical High $10.96 | Professional | 55 · Aftercare only | $3.47 | $5.89 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.98 Typical High $7.24 | Professional | 56 · Pre-op care only | $2.29 | $3.98 | $7.24 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $72.44 Median $199.53 Typical High $371.54 | Facility | 50 · Both sides | $72.44 | $199.53 | $371.54 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $43.65 Median $52.48 Typical High $114.82 | Professional | 50 · Both sides | $43.65 | $52.48 | $114.82 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $30.90 Typical High $67.61 | Professional | 54 · Surgery only | $26.30 | $30.90 | $67.61 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $5.25 Typical High $7.41 | Professional | 55 · Aftercare only | $2.88 | $5.25 | $7.41 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $34.67 Median $50.12 Typical High $87.10 | Professional | 63 · Small infant | $34.67 | $50.12 | $87.10 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.42 Median $23.99 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $20.42 | $23.99 | $53.70 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.68 Median $5.50 Typical High $12.30 | Professional | 80 · Assistant surgeon | $4.68 | $5.50 | $12.30 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.68 Median $10.23 Typical High $12.02 | Professional | 81 · Minimal assistant surgeon | $4.68 | $10.23 | $12.02 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.68 Median $10.23 Typical High $12.02 | Professional | 82 · Assistant surgeon, no resident | $4.68 | $10.23 | $12.02 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $4.07 Median $8.71 Typical High $10.47 | Professional | AS · PA/NP assist | $4.07 | $8.71 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $19.50 Typical High $36.31 | Professional | 52 · Reduced service | $13.18 | $19.50 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $7.94 Typical High $14.45 | Professional | 53 · Discontinued | $5.25 | $7.94 | $14.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.89 Typical High $10.96 | Professional | 55 · Aftercare only | $3.89 | $5.89 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.98 Typical High $7.24 | Professional | 56 · Pre-op care only | $2.63 | $3.98 | $7.24 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $61.66 Typical High $117.49 | Professional | 50 · Both sides | $61.66 | $61.66 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $54.95 | Professional | 54 · Surgery only | $28.84 | $28.84 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $7.76 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.90 Median $30.90 Typical High $58.88 | Professional | 78 · Unplanned return to OR | $30.90 | $30.90 | $58.88 |
Where Idaho sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 14th of 51
$45.71
AK $91.20VA $23.99
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.