How much rates vary
Facilitymedian $501 · 10th to 90th $141 to $1,413Professionalmedian $170 · 10th to 90th $117 to $309
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 $117.49 Median $309.03 Typical High $309.03 | Professional | None | $117.49 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $89.13 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $17.78 | $45.71 | $45.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,412.54 | Facility | None | $588.84 | $851.14 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $190.55 | Professional | None | $151.36 | $181.97 | $190.55 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $165.96 | Professional | 54 · Surgery only | $138.04 | $158.49 | $165.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $169.82 | Professional | None | $125.89 | $144.54 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $309.03 Typical High $5,495.41 | Facility | None | $79.43 | $309.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $309.03 | Professional | None | $123.03 | $190.55 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $93.33 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $18.62 | $45.71 | $45.71 |
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 $134.90 Median $165.96 Typical High $165.96 | Facility | None | $134.90 | $165.96 | $165.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | None | $165.96 | $165.96 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,412.54 | Facility | None | $776.25 | $1,096.48 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | None | $162.18 | $190.55 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $81.28 | Facility | None | $79.43 | $79.43 | $81.28 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $186.21 | Professional | None | $79.43 | $79.43 | $186.21 |
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 $112.20 Median $144.54 Typical High $208.93 | Professional | None | $112.20 | $144.54 | $208.93 |
16 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 $58.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $58.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $23.99 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.75 | $30.90 | $30.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $213.80 Typical High $223.87 | Professional | 63 · Small infant | $181.97 | $213.80 | $223.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $123.03 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $107.15 | $123.03 | $128.82 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $28.18 Typical High $29.51 | Professional | 80 · Assistant surgeon | $24.55 | $28.18 | $29.51 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $28.18 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $24.55 | $28.18 | $29.51 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $28.18 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $28.18 | $29.51 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $23.99 Typical High $25.12 | Professional | AS · PA/NP assist | $20.89 | $23.99 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $61.66 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $25.12 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.30 | $30.90 | $30.90 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 22 · Increased work | $204.17 | $204.17 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 63 · Small infant | $204.17 | $204.17 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $138.04 |
Where Idaho sits
The same service costs 4.0 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· 12th of 51
$170
AK $372FL $93.33
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.