How much rates vary
Facilitymedian $295 · 10th to 90th $155 to $1,862Professionalmedian $214 · 10th to 90th $91 to $363
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 $223.87 Median $1,412.54 Typical High $7,079.46 | Facility | None | $223.87 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $213.80 Typical High $512.86 | Professional | None | $77.62 | $213.80 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $691.83 | Facility | None | $177.83 | $281.84 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $354.81 | Professional | None | $114.82 | $251.19 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $199.53 Typical High $281.84 | Professional | None | $93.33 | $199.53 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | None | $436.52 | $436.52 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $512.86 Typical High $7,079.46 | Facility | None | $213.80 | $512.86 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $512.86 | Professional | None | $89.13 | $218.78 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $95.50 | Professional | None | $33.11 | $33.11 | $95.50 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $323.59 | Facility | None | $120.23 | $120.23 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $346.74 | Professional | None | $120.23 | $194.98 | $346.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $338.84 | Professional | None | $131.83 | $177.83 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $676.08 | Facility | None | $154.88 | $158.49 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $239.88 | Professional | None | $104.71 | $154.88 | $239.88 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $371.54 | Professional | None | $79.43 | $194.98 | $371.54 |
23 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 $45.71 Median $104.71 Typical High $257.04 | Professional | 52 · Reduced service | $45.71 | $104.71 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $42.66 Typical High $102.33 | Professional | 53 · Discontinued | $18.20 | $42.66 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $158.49 Typical High $389.05 | Professional | 54 · Surgery only | $67.61 | $158.49 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $31.62 Typical High $77.62 | Professional | 55 · Aftercare only | $13.49 | $31.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $21.38 Typical High $51.29 | Professional | 56 · Pre-op care only | $9.12 | $21.38 | $51.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $125.89 Typical High $323.59 | Professional | 54 · Surgery only | $100.00 | $125.89 | $323.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.13 Typical High $35.48 | Professional | 55 · Aftercare only | $11.48 | $14.13 | $35.48 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $70.79 Median $87.10 Typical High $223.87 | Professional | 62 · Two surgeons | $70.79 | $87.10 | $223.87 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $131.83 Median $363.08 Typical High $426.58 | Professional | 63 · Small infant | $131.83 | $363.08 | $426.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $91.20 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $77.62 | $91.20 | $245.47 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.78 Median $53.70 Typical High $58.88 | Professional | 80 · Assistant surgeon | $17.78 | $53.70 | $58.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.20 Median $46.77 Typical High $56.23 | Professional | 81 · Minimal assistant surgeon | $18.20 | $46.77 | $56.23 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $47.86 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $47.86 | $56.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $17.78 Typical High $50.12 | Professional | AS · PA/NP assist | $15.14 | $17.78 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $104.71 Typical High $257.04 | Professional | 52 · Reduced service | $45.71 | $104.71 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $42.66 Typical High $102.33 | Professional | 53 · Discontinued | $18.20 | $42.66 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $158.49 Typical High $389.05 | Professional | 54 · Surgery only | $67.61 | $158.49 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $31.62 Typical High $77.62 | Professional | 55 · Aftercare only | $13.49 | $31.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $21.38 Typical High $51.29 | Professional | 56 · Pre-op care only | $9.12 | $21.38 | $51.29 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $147.91 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $147.91 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.38 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.13 | $21.38 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $87.10 Median $131.83 Typical High $218.78 | Professional | 62 · Two surgeons | $87.10 | $131.83 | $218.78 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $158.49 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $104.71 | $158.49 | $263.03 |
Where Idaho sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$214
WI $316UT $117
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.