How much rates vary
Facilitymedian $550 · 10th to 90th $112 to $1,413Professionalmedian $112 · 10th to 90th $81 to $141
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 Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $128.82 | Professional | None | $75.86 | $128.82 | $128.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $275.42 Median $977.24 Typical High $1,412.54 | Facility | None | $275.42 | $977.24 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $141.25 | Professional | None | $109.65 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $125.89 | Professional | None | $91.20 | $109.65 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $128.82 Typical High $181.97 | Facility | None | $57.54 | $128.82 | $181.97 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $141.25 | Professional | None | $91.20 | $128.82 | $141.25 |
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 $100.00 Median $112.20 Typical High $112.20 | Facility | None | $100.00 | $112.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | None | $112.20 | $112.20 | $141.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,412.54 | Facility | None | $776.25 | $1,122.02 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | None | $109.65 | $109.65 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $57.54 Median $58.88 Typical High $1,548.82 | Facility | None | $57.54 | $58.88 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $91.20 | Professional | None | $57.54 | $57.54 | $91.20 |
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 $75.86 Median $107.15 Typical High $154.88 | Professional | None | $75.86 | $107.15 | $154.88 |
19 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 $38.02 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $38.02 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $15.14 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $11.22 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.59 | $12.88 | $12.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $309.03 Median $1,412.54 Typical High $1,949.84 | Facility | 50 · Both sides | $309.03 | $1,412.54 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $199.53 Typical High $208.93 | Professional | 50 · Both sides | $165.96 | $199.53 | $208.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $117.49 Typical High $125.89 | Professional | 54 · Surgery only | $97.72 | $117.49 | $125.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.88 Typical High $14.13 | Professional | 55 · Aftercare only | $10.96 | $12.88 | $14.13 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $67.61 Median $81.28 Typical High $87.10 | Professional | 62 · Two surgeons | $67.61 | $81.28 | $87.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $131.83 Median $154.88 Typical High $169.82 | Professional | 63 · Small infant | $131.83 | $154.88 | $169.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $91.20 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $75.86 | $91.20 | $97.72 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $20.89 Typical High $22.39 | Professional | 80 · Assistant surgeon | $17.38 | $20.89 | $22.39 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $20.89 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $17.38 | $20.89 | $22.39 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $20.89 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $20.89 | $22.39 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $14.79 Median $17.78 Typical High $19.05 | Professional | AS · PA/NP assist | $14.79 | $17.78 | $19.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $18.20 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $12.88 |
Where Idaho sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 17th of 51
$126
WI $288KY $64.57
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.