How much rates vary
Facilitymedian $214 · 10th to 90th $95 to $1,549Professionalmedian $93 · 10th to 90th $39 to $219
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $95.50 Typical High $288.40 | Professional | None | $33.88 | $95.50 | $288.40 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $436.52 Typical High $1,584.89 | Facility | None | $120.23 | $436.52 | $1,584.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $51.29 Median $147.91 Typical High $213.80 | Professional | None | $51.29 | $147.91 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $151.36 | Facility | None | $97.72 | $109.65 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $112.20 Typical High $158.49 | Professional | None | $38.90 | $112.20 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $27.54 Median $154.88 Typical High $4,466.84 | Facility | None | $27.54 | $154.88 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $100.00 Typical High $288.40 | Professional | None | $40.74 | $100.00 | $288.40 |
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 $54.95 Median $54.95 Typical High $194.98 | Facility | None | $54.95 | $54.95 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $194.98 | Professional | None | $54.95 | $69.18 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,819.70 | Facility | None | $870.96 | $1,258.93 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $199.53 | Professional | None | $54.95 | $63.10 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $954.99 | Facility | None | $93.33 | $95.50 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $93.33 Typical High $125.89 | Professional | None | $35.48 | $93.33 | $125.89 |
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 $33.11 Median $83.18 Typical High $218.78 | Professional | None | $33.11 | $83.18 | $218.78 |
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 $19.95 Median $40.74 Typical High $144.54 | Professional | 52 · Reduced service | $19.95 | $40.74 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.22 Typical High $57.54 | Professional | 53 · Discontinued | $8.13 | $16.22 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $61.66 Typical High $213.80 | Professional | 54 · Surgery only | $30.20 | $61.66 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.30 Typical High $42.66 | Professional | 55 · Aftercare only | $6.03 | $12.30 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.13 Typical High $28.84 | Professional | 56 · Pre-op care only | $4.07 | $8.13 | $28.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $56.23 Typical High $194.98 | Professional | 54 · Surgery only | $45.71 | $56.23 | $194.98 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.89 Typical High $21.38 | Professional | 55 · Aftercare only | $5.13 | $5.89 | $21.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $61.66 Median $74.13 Typical High $251.19 | Professional | 63 · Small infant | $61.66 | $74.13 | $251.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $41.69 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $35.48 | $41.69 | $144.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.13 Median $10.00 Typical High $33.88 | Professional | 80 · Assistant surgeon | $8.13 | $10.00 | $33.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.12 Median $28.84 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $9.12 | $28.84 | $34.67 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.13 Median $9.55 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $8.13 | $9.55 | $33.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $8.13 Typical High $29.51 | Professional | AS · PA/NP assist | $6.92 | $8.13 | $29.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $40.74 Typical High $144.54 | Professional | 52 · Reduced service | $19.95 | $40.74 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.22 Typical High $57.54 | Professional | 53 · Discontinued | $8.13 | $16.22 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $61.66 Typical High $213.80 | Professional | 54 · Surgery only | $30.20 | $61.66 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.30 Typical High $42.66 | Professional | 55 · Aftercare only | $6.03 | $12.30 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.13 Typical High $28.84 | Professional | 56 · Pre-op care only | $4.07 | $8.13 | $28.84 |
Where Idaho sits
The same service costs 5.4 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· 13th of 51
$126
WI $209HI $38.90
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.