How much rates vary
Facilitymedian $302 · 10th to 90th $151 to $741Professionalmedian $355 · 10th to 90th $229 to $490
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 $512.86 Median $831.76 Typical High $5,495.41 | Facility | None | $512.86 | $831.76 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $691.83 | Professional | None | $194.98 | $436.52 | $691.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $363.08 Typical High $741.31 | Facility | None | $173.78 | $363.08 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $489.78 | Professional | None | $251.19 | $371.54 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $218.78 | Facility | None | $141.25 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $446.68 | Professional | None | $229.09 | $309.03 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $4,466.84 | Facility | None | $151.36 | $436.52 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $691.83 | Professional | None | $234.42 | $416.87 | $691.83 |
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 $269.15 Median $269.15 Typical High $446.68 | Facility | None | $269.15 | $269.15 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $457.09 | Professional | None | $269.15 | $331.13 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $794.33 | Facility | None | $407.38 | $588.84 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $446.68 | Professional | None | $281.84 | $309.03 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $602.56 | Facility | None | $213.80 | $218.78 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $288.40 | Professional | None | $169.82 | $213.80 | $288.40 |
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 $181.97 Median $302.00 Typical High $512.86 | Professional | None | $181.97 | $302.00 | $512.86 |
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 $117.49 Median $213.80 Typical High $346.74 | Professional | 52 · Reduced service | $117.49 | $213.80 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $87.10 Typical High $138.04 | Professional | 53 · Discontinued | $46.77 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $323.59 Typical High $512.86 | Professional | 54 · Surgery only | $177.83 | $323.59 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $64.57 Typical High $102.33 | Professional | 55 · Aftercare only | $35.48 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $42.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $23.44 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $302.00 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $165.96 | $302.00 | $478.63 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $275.42 Typical High $436.52 | Professional | 54 · Surgery only | $223.87 | $275.42 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $302.00 Median $354.81 Typical High $562.34 | Professional | 63 · Small infant | $302.00 | $354.81 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $338.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $46.77 Typical High $81.28 | Professional | 80 · Assistant surgeon | $38.90 | $46.77 | $81.28 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $48.98 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $39.81 | $48.98 | $81.28 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $46.77 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $46.77 | $69.18 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $41.69 Typical High $69.18 | Professional | AS · PA/NP assist | $34.67 | $41.69 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $213.80 Typical High $346.74 | Professional | 52 · Reduced service | $117.49 | $213.80 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $87.10 Typical High $138.04 | Professional | 53 · Discontinued | $46.77 | $87.10 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $323.59 Typical High $512.86 | Professional | 54 · Surgery only | $177.83 | $323.59 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $64.57 Typical High $102.33 | Professional | 55 · Aftercare only | $35.48 | $64.57 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $42.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $23.44 | $42.66 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $302.00 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $165.96 | $302.00 | $478.63 |
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· 9th of 51
$355
WI $708TX $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.