How much rates vary
Facilitymedian $339 · 10th to 90th $182 to $1,230Professionalmedian $331 · 10th to 90th $186 to $575
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $676.08 | Professional | None | $181.97 | $331.13 | $676.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $1,230.27 | Facility | None | $234.42 | $354.81 | $1,230.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $575.44 | Professional | None | $208.93 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $363.08 | Facility | None | $234.42 | $263.03 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $426.58 | Professional | None | $186.21 | $302.00 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $389.05 Typical High $5,495.41 | Facility | None | $165.96 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $676.08 | Professional | None | $194.98 | $331.13 | $676.08 |
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 $229.09 Median $229.09 Typical High $524.81 | Facility | None | $229.09 | $229.09 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $537.03 | Professional | None | $229.09 | $269.15 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,348.96 | Facility | None | $724.44 | $1,047.13 | $1,348.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $549.54 | Professional | None | $257.04 | $288.40 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $588.84 | Facility | None | $251.19 | $257.04 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $338.84 | Professional | None | $144.54 | $251.19 | $338.84 |
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 $144.54 Median $281.84 Typical High $501.19 | Professional | None | $144.54 | $281.84 | $501.19 |
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 $91.20 Median $162.18 Typical High $331.13 | Professional | 52 · Reduced service | $91.20 | $162.18 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $66.07 Typical High $134.90 | Professional | 53 · Discontinued | $36.31 | $66.07 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $245.47 Typical High $501.19 | Professional | 54 · Surgery only | $134.90 | $245.47 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $48.98 Typical High $100.00 | Professional | 55 · Aftercare only | $26.92 | $48.98 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.11 Typical High $67.61 | Professional | 56 · Pre-op care only | $18.20 | $33.11 | $67.61 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $251.19 Median $501.19 Typical High $1,862.09 | Facility | 50 · Both sides | $251.19 | $501.19 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $380.19 Typical High $851.14 | Professional | 50 · Both sides | $316.23 | $380.19 | $851.14 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $229.09 Typical High $501.19 | Professional | 54 · Surgery only | $190.55 | $229.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $25.12 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $25.12 | $51.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $251.19 Median $616.60 Typical High $707.95 | Professional | 63 · Small infant | $251.19 | $616.60 | $707.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $398.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $40.74 Typical High $89.13 | Professional | 80 · Assistant surgeon | $38.02 | $40.74 | $89.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.88 Median $39.81 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $33.88 | $39.81 | $95.50 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.88 Median $40.74 Typical High $91.20 | Professional | 82 · Assistant surgeon, no resident | $33.88 | $40.74 | $91.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $34.67 Typical High $77.62 | Professional | AS · PA/NP assist | $28.84 | $34.67 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $162.18 Typical High $331.13 | Professional | 52 · Reduced service | $91.20 | $162.18 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $66.07 Typical High $134.90 | Professional | 53 · Discontinued | $36.31 | $66.07 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $245.47 Typical High $501.19 | Professional | 54 · Surgery only | $134.90 | $245.47 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $48.98 Typical High $100.00 | Professional | 55 · Aftercare only | $26.92 | $48.98 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.11 Typical High $67.61 | Professional | 56 · Pre-op care only | $18.20 | $33.11 | $67.61 |
Where Idaho sits
The same service costs 3.2 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· 15th of 51
$331
WI $646KY $204
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.