How much rates vary
Facilitymedian $550 · 10th to 90th $74 to $1,413Professionalmedian $74 · 10th to 90th $55 to $91
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 $50.12 Median $85.11 Typical High $85.11 | Professional | None | $50.12 | $85.11 | $85.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $245.47 Median $977.24 Typical High $1,412.54 | Facility | None | $245.47 | $977.24 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $93.33 | Professional | None | $70.79 | $83.18 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $83.18 | Professional | None | $60.26 | $72.44 | $83.18 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $85.11 Typical High $120.23 | Facility | None | $38.02 | $85.11 | $120.23 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $91.20 | Professional | None | $60.26 | $85.11 | $91.20 |
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 $66.07 Median $74.13 Typical High $74.13 | Facility | None | $66.07 | $74.13 | $74.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | None | $74.13 | $74.13 | $93.33 |
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 $70.79 Median $70.79 Typical High $91.20 | Professional | None | $70.79 | $70.79 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $38.90 Typical High $1,548.82 | Facility | None | $38.02 | $38.90 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $60.26 | Professional | None | $38.02 | $38.02 | $60.26 |
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 $50.12 Median $69.18 Typical High $102.33 | Professional | None | $50.12 | $69.18 | $102.33 |
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 $25.12 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $25.12 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $10.00 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $7.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.01 | $8.51 | $8.51 |
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 $107.15 Median $131.83 Typical High $138.04 | Professional | 50 · Both sides | $107.15 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $77.62 Typical High $83.18 | Professional | 54 · Surgery only | $64.57 | $77.62 | $83.18 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.51 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $8.51 | $9.33 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $44.67 Median $53.70 Typical High $57.54 | Professional | 62 · Two surgeons | $44.67 | $53.70 | $57.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $87.10 Median $102.33 Typical High $112.20 | Professional | 63 · Small infant | $87.10 | $102.33 | $112.20 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $60.26 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $50.12 | $60.26 | $64.57 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $13.80 Typical High $14.79 | Professional | 80 · Assistant surgeon | $11.48 | $13.80 | $14.79 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.48 Median $13.80 Typical High $14.79 | Professional | 81 · Minimal assistant surgeon | $11.48 | $13.80 | $14.79 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.48 Median $13.80 Typical High $14.79 | Professional | 82 · Assistant surgeon, no resident | $11.48 | $13.80 | $14.79 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $9.77 Median $11.75 Typical High $12.59 | Professional | AS · PA/NP assist | $9.77 | $11.75 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $30.20 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $12.02 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.03 | $8.51 | $8.51 |
Where Idaho sits
The same service costs 4.7 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· 18th of 51
$83.18
WI $200KY $42.66
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.