How much rates vary
Facilitymedian $646 · 10th to 90th $105 to $2,754Professionalmedian $269 · 10th to 90th $162 to $437
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 $389.05 Median $645.65 Typical High $5,495.41 | Facility | None | $389.05 | $645.65 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $323.59 Typical High $549.54 | Professional | None | $138.04 | $323.59 | $549.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $52.48 Median $1,174.90 Typical High $2,754.23 | Facility | None | $52.48 | $1,174.90 | $2,754.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $436.52 | Professional | None | $208.93 | $309.03 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $309.03 | Professional | None | $158.49 | $218.78 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $467.74 Typical High $10,471.29 | Facility | None | $162.18 | $467.74 | $10,471.29 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $549.54 | Professional | None | $190.55 | $323.59 | $549.54 |
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 $223.87 Median $223.87 Typical High $407.38 | Facility | None | $223.87 | $223.87 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $407.38 | Professional | None | $223.87 | $275.42 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $2,951.21 | Facility | None | $1,318.26 | $2,041.74 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $380.19 | Professional | None | $218.78 | $251.19 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $194.98 | Facility | None | $125.89 | $194.98 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $251.19 | Professional | None | $144.54 | $194.98 | $251.19 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $398.11 | Professional | None | $128.82 | $218.78 | $398.11 |
20 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 $81.28 Median $162.18 Typical High $275.42 | Professional | 52 · Reduced service | $81.28 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $64.57 Typical High $109.65 | Professional | 53 · Discontinued | $32.36 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $245.47 Typical High $407.38 | Professional | 54 · Surgery only | $123.03 | $245.47 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $48.98 Typical High $81.28 | Professional | 55 · Aftercare only | $24.55 | $48.98 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $32.36 Typical High $54.95 | Professional | 56 · Pre-op care only | $16.22 | $32.36 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $229.09 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $114.82 | $229.09 | $380.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $223.87 Typical High $398.11 | Professional | 54 · Surgery only | $190.55 | $223.87 | $398.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $43.65 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $251.19 Median $446.68 Typical High $549.54 | Professional | 63 · Small infant | $251.19 | $446.68 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $177.83 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $147.91 | $177.83 | $316.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $39.81 Typical High $72.44 | Professional | 80 · Assistant surgeon | $33.11 | $39.81 | $72.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $38.90 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $33.11 | $38.90 | $72.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $48.98 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $48.98 | $72.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $33.88 Typical High $61.66 | Professional | AS · PA/NP assist | $28.18 | $33.88 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $162.18 Typical High $275.42 | Professional | 52 · Reduced service | $81.28 | $162.18 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $64.57 Typical High $109.65 | Professional | 53 · Discontinued | $32.36 | $64.57 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $245.47 Typical High $407.38 | Professional | 54 · Surgery only | $123.03 | $245.47 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $48.98 Typical High $81.28 | Professional | 55 · Aftercare only | $24.55 | $48.98 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $32.36 Typical High $54.95 | Professional | 56 · Pre-op care only | $16.22 | $32.36 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $229.09 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $114.82 | $229.09 | $380.19 |
Where Idaho sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 9th of 51
$295
WI $589HI $155
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.