How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,072 to $11,220Professionalmedian $295 · 10th to 90th $219 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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $346.74 | Professional | None | $199.53 | $346.74 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $12,022.64 | Facility | None | $3,019.95 | $4,570.88 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $363.08 | Professional | None | $288.40 | $316.23 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $3,981.07 | Facility | None | $2,630.27 | $2,951.21 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $338.84 | Professional | None | $251.19 | $295.12 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $346.74 Typical High $5,495.41 | Facility | None | $147.91 | $346.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $371.54 | Professional | None | $257.04 | $316.23 | $371.54 |
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 $251.19 Median $288.40 Typical High $288.40 | Facility | None | $251.19 | $288.40 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | None | $288.40 | $288.40 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,762.47 Median $11,220.18 Typical High $15,135.61 | Facility | None | $7,762.47 | $11,220.18 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $371.54 | Professional | None | $288.40 | $288.40 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $239.88 | Professional | None | $147.91 | $147.91 | $239.88 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $416.87 | Professional | None | $204.17 | $275.42 | $416.87 |
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 $100.00 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $100.00 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $39.81 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $151.36 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $30.20 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.95 | $34.67 | $34.67 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $295.12 | $331.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $36.31 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $398.11 Typical High $436.52 | Professional | 63 · Small infant | $331.13 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $229.09 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $194.98 | $229.09 | $257.04 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $52.48 Typical High $58.88 | Professional | 80 · Assistant surgeon | $44.67 | $52.48 | $58.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $44.67 Median $52.48 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $44.67 | $52.48 | $58.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $52.48 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $52.48 | $58.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $44.67 Typical High $50.12 | Professional | AS · PA/NP assist | $38.02 | $44.67 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $190.55 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $38.02 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $34.67 |
Where Idaho sits
The same service costs 10.2 times more in Oklahoma 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· 20th of 51
$347
OK $1,950KY $191
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.