How much rates vary
Facilitymedian $1,096 · 10th to 90th $407 to $4,467Professionalmedian $355 · 10th to 90th $224 to $562
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 $457.09 Median $724.44 Typical High $5,495.41 | Facility | None | $457.09 | $724.44 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $407.38 Typical High $602.56 | Professional | None | $199.53 | $407.38 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $4,897.79 | Facility | None | $1,096.48 | $2,137.96 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $426.58 Typical High $549.54 | Professional | None | $257.04 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,412.54 | Facility | None | $933.25 | $1,047.13 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $389.05 | Professional | None | $229.09 | $295.12 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $602.56 Typical High $4,365.16 | Facility | None | $245.47 | $602.56 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $602.56 | Professional | None | $229.09 | $407.38 | $602.56 |
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 $281.84 Median $281.84 Typical High $501.19 | Facility | None | $281.84 | $281.84 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $512.86 | Professional | None | $281.84 | $323.59 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $5,495.41 | Facility | None | $2,884.03 | $4,168.69 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $501.19 | Professional | None | $323.59 | $354.81 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $3,981.07 | Facility | None | $239.88 | $245.47 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $323.59 | Professional | None | $177.83 | $239.88 | $323.59 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $524.81 | Professional | None | $186.21 | $309.03 | $524.81 |
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 $112.20 Median $204.17 Typical High $302.00 | Professional | 52 · Reduced service | $112.20 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $81.28 Typical High $123.03 | Professional | 53 · Discontinued | $44.67 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $169.82 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $33.88 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $40.74 Typical High $60.26 | Professional | 56 · Pre-op care only | $22.39 | $40.74 | $60.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,659.59 Median $3,235.94 Typical High $7,413.10 | Facility | 50 · Both sides | $1,659.59 | $3,235.94 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $707.95 Typical High $831.76 | Professional | 50 · Both sides | $389.05 | $707.95 | $831.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $389.05 Typical High $512.86 | Professional | 54 · Surgery only | $234.42 | $389.05 | $512.86 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $54.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $309.03 Median $371.54 Typical High $660.69 | Professional | 63 · Small infant | $309.03 | $371.54 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $218.78 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $181.97 | $218.78 | $398.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $61.66 Typical High $87.10 | Professional | 80 · Assistant surgeon | $41.69 | $61.66 | $87.10 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $50.12 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $42.66 | $50.12 | $83.18 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $50.12 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $50.12 | $87.10 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $42.66 Typical High $74.13 | Professional | AS · PA/NP assist | $35.48 | $42.66 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $204.17 Typical High $302.00 | Professional | 52 · Reduced service | $112.20 | $204.17 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $81.28 Typical High $123.03 | Professional | 53 · Discontinued | $44.67 | $81.28 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $169.82 | $302.00 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $33.88 | $60.26 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $40.74 Typical High $60.26 | Professional | 56 · Pre-op care only | $22.39 | $40.74 | $60.26 |
Where Idaho sits
The same service costs 3.1 times more in Alaska than in New York. 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· 13th of 51
$407
AK $794NY $257
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.