How much rates vary
Facilitymedian $550 · 10th to 90th $21 to $1,413Professionalmedian $19 · 10th to 90th $15 to $23
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 $12.59 Median $21.38 Typical High $21.38 | Professional | None | $12.59 | $21.38 | $21.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $154.88 Median $977.24 Typical High $1,412.54 | Facility | None | $154.88 | $977.24 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $23.44 | Professional | None | $17.78 | $20.89 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $20.89 | Professional | None | $15.49 | $18.20 | $20.89 |
Moda Health Setting Facility Modifier None Typical Low $9.77 Median $21.38 Typical High $74.13 | Facility | None | $9.77 | $21.38 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $15.14 Median $21.38 Typical High $23.44 | Professional | None | $15.14 | $21.38 | $23.44 |
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 $16.60 Median $19.05 Typical High $19.05 | Facility | None | $16.60 | $19.05 | $19.05 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | None | $19.05 | $19.05 | $23.44 |
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 $17.78 Median $17.78 Typical High $22.91 | Professional | None | $17.78 | $17.78 | $22.91 |
Select Health Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $1,548.82 | Facility | None | $9.77 | $9.77 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $15.14 | Professional | None | $9.77 | $9.77 | $15.14 |
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 $12.88 Median $17.78 Typical High $25.70 | Professional | None | $12.88 | $17.78 | $25.70 |
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 $6.31 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $6.31 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $2.51 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $1.91 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.26 | $2.14 | $2.14 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $85.11 Median $1,412.54 Typical High $1,949.84 | Facility | 50 · Both sides | $85.11 | $1,412.54 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $27.54 Median $33.11 Typical High $35.48 | Professional | 50 · Both sides | $27.54 | $33.11 | $35.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $19.50 Typical High $20.89 | Professional | 54 · Surgery only | $16.60 | $19.50 | $20.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.19 Typical High $2.34 | Professional | 55 · Aftercare only | $1.82 | $2.19 | $2.34 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $11.48 Median $13.49 Typical High $14.79 | Professional | 62 · Two surgeons | $11.48 | $13.49 | $14.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $21.88 Median $25.70 Typical High $28.18 | Professional | 63 · Small infant | $21.88 | $25.70 | $28.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $12.88 Median $15.14 Typical High $16.22 | Professional | 78 · Unplanned return to OR | $12.88 | $15.14 | $16.22 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.95 Median $3.47 Typical High $3.72 | Professional | 80 · Assistant surgeon | $2.95 | $3.47 | $3.72 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.95 Median $3.47 Typical High $3.72 | Professional | 81 · Minimal assistant surgeon | $2.95 | $3.47 | $3.72 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.95 Median $3.47 Typical High $3.72 | Professional | 82 · Assistant surgeon, no resident | $2.95 | $3.47 | $3.72 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $2.51 Median $2.95 Typical High $3.16 | Professional | AS · PA/NP assist | $2.51 | $2.95 | $3.16 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $7.59 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.09 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.29 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.51 | $2.14 | $2.14 |
Where Idaho sits
The same service costs 12.3 times more in Florida 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· 19th of 51
$21.38
FL $132KY $10.72
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.