How much rates vary
Facilitymedian $229 · 10th to 90th $91 to $708Professionalmedian $112 · 10th to 90th $72 to $182
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $263.03 | Professional | None | $58.88 | $117.49 | $263.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $812.83 | Facility | None | $199.53 | $239.88 | $812.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $186.21 | Professional | None | $83.18 | $128.82 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $141.25 | Professional | None | $75.86 | $97.72 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $204.17 Typical High $4,466.84 | Facility | None | $67.61 | $204.17 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $151.36 Typical High $263.03 | Professional | None | $74.13 | $151.36 | $263.03 |
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 $91.20 Median $91.20 Typical High $169.82 | Facility | None | $91.20 | $91.20 | $169.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $169.82 | Professional | None | $91.20 | $112.20 | $169.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $173.78 | Professional | None | $104.71 | $112.20 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $257.04 | Facility | None | $81.28 | $83.18 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $109.65 | Professional | None | $56.23 | $81.28 | $109.65 |
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 $60.26 Median $107.15 Typical High $177.83 | Professional | None | $60.26 | $107.15 | $177.83 |
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 $33.88 Median $83.18 Typical High $131.83 | Professional | 52 · Reduced service | $33.88 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $33.88 Typical High $52.48 | Professional | 53 · Discontinued | $13.49 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $50.12 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $25.12 Typical High $39.81 | Professional | 55 · Aftercare only | $10.23 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $16.60 Typical High $26.30 | Professional | 56 · Pre-op care only | $6.76 | $16.60 | $26.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $162.18 | Professional | 54 · Surgery only | $75.86 | $91.20 | $162.18 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $8.13 | $15.85 | $19.05 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $112.20 Median $190.55 Typical High $223.87 | Professional | 63 · Small infant | $112.20 | $190.55 | $223.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $77.62 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $58.88 | $77.62 | $134.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $16.22 Typical High $30.20 | Professional | 80 · Assistant surgeon | $13.49 | $16.22 | $30.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $25.12 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $15.14 | $25.12 | $30.20 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $17.78 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $17.78 | $30.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $11.22 Median $13.80 Typical High $25.12 | Professional | AS · PA/NP assist | $11.22 | $13.80 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $83.18 Typical High $131.83 | Professional | 52 · Reduced service | $36.31 | $83.18 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $33.88 Typical High $52.48 | Professional | 53 · Discontinued | $14.45 | $33.88 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $53.70 | $125.89 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $25.12 Typical High $39.81 | Professional | 55 · Aftercare only | $10.72 | $25.12 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $16.60 Typical High $26.30 | Professional | 56 · Pre-op care only | $7.24 | $16.60 | $26.30 |
Where Idaho sits
The same service costs 3.7 times more in Wisconsin 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· 9th of 51
$135
WI $282FL $75.86
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.