How much rates vary
Facilitymedian $126 · 10th to 90th $69 to $437Professionalmedian $40 · 10th to 90th $23 to $170
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 $19.50 Median $63.10 Typical High $169.82 | Professional | None | $19.50 | $63.10 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $416.87 | Facility | None | $77.62 | $107.15 | $416.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $26.30 Median $112.20 Typical High $158.49 | Professional | None | $26.30 | $112.20 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $107.15 | Facility | None | $69.18 | $77.62 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $67.61 Typical High $131.83 | Professional | None | $22.91 | $67.61 | $131.83 |
Moda Health Setting Facility Modifier None Typical Low $19.50 Median $48.98 Typical High $169.82 | Facility | None | $19.50 | $48.98 | $169.82 |
Moda Health Setting Professional Modifier None Typical Low $21.88 Median $67.61 Typical High $169.82 | Professional | None | $21.88 | $67.61 | $169.82 |
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 $27.54 Median $27.54 Typical High $144.54 | Facility | None | $27.54 | $27.54 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $181.97 | Professional | None | $27.54 | $35.48 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $512.86 | Facility | None | $275.42 | $389.05 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $194.98 | Professional | None | $30.90 | $57.54 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $70.79 | Facility | None | $69.18 | $69.18 | $70.79 |
Select Health Setting Professional Modifier None Typical Low $16.60 Median $69.18 Typical High $100.00 | Professional | None | $16.60 | $69.18 | $100.00 |
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 $17.78 Median $66.07 Typical High $141.25 | Professional | None | $17.78 | $66.07 | $141.25 |
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 $9.77 Median $33.88 Typical High $85.11 | Professional | 52 · Reduced service | $9.77 | $33.88 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $13.49 Typical High $33.88 | Professional | 53 · Discontinued | $3.89 | $13.49 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $10.00 Typical High $25.12 | Professional | 55 · Aftercare only | $2.95 | $10.00 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $6.76 Typical High $16.98 | Professional | 56 · Pre-op care only | $1.95 | $6.76 | $16.98 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $158.49 Typical High $616.60 | Facility | 50 · Both sides | $117.49 | $158.49 | $616.60 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $38.02 Median $45.71 Typical High $239.88 | Professional | 50 · Both sides | $38.02 | $45.71 | $239.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $32.36 Typical High $141.25 | Professional | 54 · Surgery only | $22.91 | $32.36 | $141.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.95 Typical High $15.14 | Professional | 55 · Aftercare only | $2.51 | $2.95 | $15.14 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $30.20 Median $35.48 Typical High $194.98 | Professional | 63 · Small infant | $30.20 | $35.48 | $194.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.95 Median $97.72 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $19.95 | $97.72 | $114.82 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.07 Median $4.90 Typical High $23.99 | Professional | 80 · Assistant surgeon | $4.07 | $4.90 | $23.99 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.07 Median $5.75 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $4.07 | $5.75 | $26.30 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.07 Median $4.79 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $4.07 | $4.79 | $26.30 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $3.47 Median $18.20 Typical High $21.38 | Professional | AS · PA/NP assist | $3.47 | $18.20 | $21.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $16.98 Typical High $85.11 | Professional | 52 · Reduced service | $9.77 | $16.98 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $6.76 Typical High $33.88 | Professional | 53 · Discontinued | $3.89 | $6.76 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $5.13 Typical High $25.12 | Professional | 55 · Aftercare only | $2.95 | $5.13 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $3.39 Typical High $16.98 | Professional | 56 · Pre-op care only | $1.95 | $3.39 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $53.70 Typical High $263.03 | Professional | 50 · Both sides | $53.70 | $53.70 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $123.03 | Professional | 54 · Surgery only | $25.12 | $25.12 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $17.78 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $17.78 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $26.92 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $26.92 | $26.92 | $131.83 |
Where Idaho sits
The same service costs 5.9 times more in Iowa 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· 17th of 51
$79.43
IA $117KY $19.95
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.