How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,072 to $20,893Professionalmedian $832 · 10th to 90th $525 to $1,122
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $1,122.02 Typical High $1,122.02 | Professional | None | $478.63 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,511.89 Median $9,772.37 Typical High $26,915.35 | Facility | None | $2,511.89 | $9,772.37 | $26,915.35 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $933.25 | Professional | None | $776.25 | $912.01 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $794.33 | Professional | None | $588.84 | $676.08 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,122.02 Typical High $5,495.41 | Facility | None | $575.44 | $1,122.02 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,122.02 | Professional | None | $630.96 | $891.25 | $1,122.02 |
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 $691.83 Median $831.76 Typical High $831.76 | Facility | None | $691.83 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $19,498.45 Typical High $33,884.42 | Facility | None | $9,772.37 | $19,498.45 | $33,884.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $977.24 | Professional | None | $812.83 | $933.25 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $9,549.93 | Facility | None | $398.11 | $407.38 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | None | $398.11 | $398.11 | $588.84 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,023.29 | Professional | None | $489.78 | $707.95 | $1,023.29 |
18 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 $269.15 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $269.15 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $107.15 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $407.38 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $81.28 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $53.70 | $112.20 | $112.20 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $776.25 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $912.01 Median $1,023.29 Typical High $1,122.02 | Professional | 63 · Small infant | $912.01 | $1,023.29 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $660.69 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $138.04 Typical High $151.36 | Professional | 80 · Assistant surgeon | $120.23 | $138.04 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $138.04 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $120.23 | $138.04 | $151.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $138.04 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $138.04 | $151.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $117.49 Typical High $128.82 | Professional | AS · PA/NP assist | $102.33 | $117.49 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $316.23 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $125.89 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $467.74 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $93.33 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $63.10 | $112.20 | $112.20 |
Where Idaho sits
The same service costs 3.9 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· 19th of 51
$912
AK $1,905NY $490
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.