How much rates vary
Facilitymedian $398 · 10th to 90th $214 to $1,820Professionalmedian $427 · 10th to 90th $282 to $617
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $575.44 Typical High $831.76 | Professional | None | $281.84 | $575.44 | $831.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $1,819.70 | Facility | None | $251.19 | $870.96 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $616.60 | Professional | None | $331.13 | $436.52 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $323.59 | Facility | None | $208.93 | $234.42 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $457.09 | Professional | None | $281.84 | $363.08 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $831.76 Typical High $5,495.41 | Facility | None | $208.93 | $831.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $831.76 | Professional | None | $302.00 | $512.86 | $831.76 |
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 $363.08 Median $363.08 Typical High $562.34 | Facility | None | $363.08 | $363.08 | $562.34 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $575.44 | Professional | None | $363.08 | $426.58 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,819.70 | Facility | None | $870.96 | $1,288.25 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | None | $380.19 | $426.58 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $4,265.80 | Facility | None | $269.15 | $275.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $363.08 | Professional | None | $229.09 | $269.15 | $363.08 |
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 $229.09 Median $371.54 Typical High $616.60 | Professional | None | $229.09 | $371.54 | $616.60 |
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 $141.25 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $141.25 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $114.82 Typical High $165.96 | Professional | 53 · Discontinued | $56.23 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $208.93 | $436.52 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $41.69 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $83.18 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $194.98 | $407.38 | $588.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $309.03 | $363.08 | $562.34 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $37.15 | $52.48 | $63.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $630.96 Typical High $741.31 | Professional | 63 · Small infant | $398.11 | $630.96 | $741.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $446.68 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $97.72 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $97.72 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $83.18 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $53.70 | $83.18 | $97.72 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $52.48 Median $83.18 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $52.48 | $83.18 | $97.72 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $79.43 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $141.25 | $288.40 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $114.82 Typical High $165.96 | Professional | 53 · Discontinued | $56.23 | $114.82 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $208.93 | $436.52 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $41.69 | $87.10 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $83.18 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $194.98 | $407.38 | $588.84 |
Where Idaho sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 12th of 51
$417
WI $891TX $240
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.