How much rates vary
Facilitymedian $155 · 10th to 90th $81 to $676Professionalmedian $155 · 10th to 90th $107 to $234
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 $95.50 Median $154.88 Typical High $213.80 | Professional | None | $95.50 | $154.88 | $213.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $81.28 Median $147.91 Typical High $691.83 | Facility | None | $81.28 | $147.91 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $245.47 | Professional | None | $120.23 | $173.78 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $114.82 | Facility | None | $75.86 | $85.11 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $165.96 | Professional | None | $97.72 | $120.23 | $165.96 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $154.88 Typical High $309.03 | Facility | None | $85.11 | $154.88 | $309.03 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $213.80 | Professional | None | $112.20 | $181.97 | $213.80 |
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 $223.87 | Facility | None | $128.82 | $128.82 | $223.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $288.40 | Professional | None | $128.82 | $165.96 | $288.40 |
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 $154.88 Median $181.97 Typical High $257.04 | Professional | None | $154.88 | $181.97 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $316.23 | Facility | None | $107.15 | $109.65 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $138.04 | Professional | None | $75.86 | $107.15 | $138.04 |
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 $85.11 Median $123.03 Typical High $190.55 | Professional | None | $85.11 | $123.03 | $190.55 |
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 $47.86 Median $77.62 Typical High $107.15 | Professional | 52 · Reduced service | $47.86 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $30.90 Typical High $42.66 | Professional | 53 · Discontinued | $19.50 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $14.45 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.55 | $15.49 | $21.38 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $218.78 Typical High $1,047.13 | Facility | 50 · Both sides | $117.49 | $218.78 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $316.23 Typical High $380.19 | Professional | 50 · Both sides | $186.21 | $316.23 | $380.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $131.83 Typical High $223.87 | Professional | 54 · Surgery only | $107.15 | $131.83 | $223.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.60 Typical High $24.55 | Professional | 55 · Aftercare only | $12.02 | $16.60 | $24.55 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $144.54 Median $173.78 Typical High $288.40 | Professional | 63 · Small infant | $144.54 | $173.78 | $288.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $117.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $83.18 | $117.49 | $177.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $30.90 Typical High $39.81 | Professional | 80 · Assistant surgeon | $19.50 | $30.90 | $39.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $26.92 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $19.05 | $26.92 | $39.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $23.44 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $23.44 | $39.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $19.50 Typical High $32.36 | Professional | AS · PA/NP assist | $16.22 | $19.50 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $77.62 Typical High $107.15 | Professional | 52 · Reduced service | $47.86 | $77.62 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $30.90 Typical High $42.66 | Professional | 53 · Discontinued | $19.50 | $30.90 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $14.45 | $23.44 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.55 | $15.49 | $21.38 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $251.19 Typical High $354.81 | Professional | 50 · Both sides | $251.19 | $251.19 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $117.49 | $117.49 | $165.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $23.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $177.83 |
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· 9th of 51
$155
AK $309FL $81.28
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.