How much rates vary
Facilitymedian $288 · 10th to 90th $148 to $724Professionalmedian $295 · 10th to 90th $166 to $550
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 $131.83 Median $295.12 Typical High $660.69 | Professional | None | $131.83 | $295.12 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $630.96 | Facility | None | $173.78 | $288.40 | $630.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $549.54 | Professional | None | $199.53 | $371.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $218.78 | Facility | None | $141.25 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $416.87 | Professional | None | $165.96 | $263.03 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $524.81 Typical High $4,466.84 | Facility | None | $165.96 | $524.81 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $660.69 | Professional | None | $181.97 | $295.12 | $660.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $501.19 | Facility | None | $213.80 | $213.80 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $512.86 | Professional | None | $213.80 | $263.03 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $794.33 | Facility | None | $407.38 | $588.84 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $537.03 | Professional | None | $234.42 | $263.03 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $537.03 | Facility | None | $239.88 | $245.47 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $331.13 | Professional | None | $138.04 | $239.88 | $331.13 |
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 $128.82 Median $251.19 Typical High $457.09 | Professional | None | $128.82 | $251.19 | $457.09 |
20 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 $83.18 Median $144.54 Typical High $331.13 | Professional | 52 · Reduced service | $83.18 | $144.54 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $58.88 Typical High $131.83 | Professional | 53 · Discontinued | $33.11 | $58.88 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $218.78 Typical High $489.78 | Professional | 54 · Surgery only | $123.03 | $218.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $43.65 Typical High $97.72 | Professional | 55 · Aftercare only | $25.12 | $43.65 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $29.51 Typical High $66.07 | Professional | 56 · Pre-op care only | $16.60 | $29.51 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $204.17 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $114.82 | $204.17 | $457.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $218.78 Typical High $501.19 | Professional | 54 · Surgery only | $186.21 | $218.78 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.44 Typical High $56.23 | Professional | 55 · Aftercare only | $19.95 | $23.44 | $56.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $239.88 Median $467.74 Typical High $660.69 | Professional | 63 · Small infant | $239.88 | $467.74 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $138.04 | $169.82 | $389.05 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $37.15 Typical High $89.13 | Professional | 80 · Assistant surgeon | $31.62 | $37.15 | $89.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $38.90 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $31.62 | $38.90 | $89.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $38.90 Typical High $91.20 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $38.90 | $91.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $63.10 Typical High $77.62 | Professional | AS · PA/NP assist | $30.20 | $63.10 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $144.54 Typical High $331.13 | Professional | 52 · Reduced service | $83.18 | $144.54 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $58.88 Typical High $131.83 | Professional | 53 · Discontinued | $33.11 | $58.88 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $218.78 Typical High $489.78 | Professional | 54 · Surgery only | $123.03 | $218.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $43.65 Typical High $97.72 | Professional | 55 · Aftercare only | $25.12 | $43.65 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $29.51 Typical High $66.07 | Professional | 56 · Pre-op care only | $16.60 | $29.51 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $204.17 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $114.82 | $204.17 | $457.09 |
Where Idaho sits
The same service costs 3.6 times more in Wisconsin 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· 10th of 51
$295
WI $490KY $135
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.