How much rates vary
Facilitymedian $490 · 10th to 90th $288 to $1,660Professionalmedian $457 · 10th to 90th $302 to $661
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 $416.87 Median $1,412.54 Typical High $7,079.46 | Facility | None | $416.87 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $562.34 Typical High $912.01 | Professional | None | $251.19 | $562.34 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $1,659.59 | Facility | None | $380.19 | $776.25 | $1,659.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Professional | None | $346.74 | $467.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $489.78 | Facility | None | $323.59 | $363.08 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $562.34 | Professional | None | $302.00 | $398.11 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $676.08 Typical High $5,495.41 | Facility | None | $269.15 | $676.08 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $912.01 | Professional | None | $323.59 | $549.54 | $912.01 |
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 $380.19 Median $380.19 Typical High $602.56 | Facility | None | $380.19 | $380.19 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $616.60 | Professional | None | $380.19 | $457.09 | $616.60 |
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 $389.05 Median $426.58 Typical High $588.84 | Professional | None | $389.05 | $426.58 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $1,862.09 | Facility | None | $288.40 | $295.12 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $380.19 | Professional | None | $239.88 | $288.40 | $380.19 |
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 $251.19 Median $389.05 Typical High $645.65 | Professional | None | $251.19 | $389.05 | $645.65 |
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 $162.18 Median $302.00 Typical High $457.09 | Professional | 52 · Reduced service | $162.18 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $120.23 Typical High $181.97 | Professional | 53 · Discontinued | $64.57 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $457.09 Typical High $676.08 | Professional | 54 · Surgery only | $239.88 | $457.09 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $91.20 Typical High $134.90 | Professional | 55 · Aftercare only | $48.98 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $60.26 Typical High $91.20 | Professional | 56 · Pre-op care only | $32.36 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $223.87 | $426.58 | $630.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $588.84 | Professional | 54 · Surgery only | $316.23 | $380.19 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $426.58 Median $501.19 Typical High $758.58 | Professional | 63 · Small infant | $426.58 | $501.19 | $758.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $288.40 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $251.19 | $288.40 | $478.63 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $66.07 Typical High $109.65 | Professional | 80 · Assistant surgeon | $53.70 | $66.07 | $109.65 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $91.20 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $53.70 | $91.20 | $109.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $67.61 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $67.61 | $104.71 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $57.54 Typical High $89.13 | Professional | AS · PA/NP assist | $48.98 | $57.54 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $302.00 Typical High $457.09 | Professional | 52 · Reduced service | $162.18 | $302.00 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $120.23 Typical High $181.97 | Professional | 53 · Discontinued | $64.57 | $120.23 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $457.09 Typical High $676.08 | Professional | 54 · Surgery only | $239.88 | $457.09 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $91.20 Typical High $134.90 | Professional | 55 · Aftercare only | $48.98 | $91.20 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $60.26 Typical High $91.20 | Professional | 56 · Pre-op care only | $32.36 | $60.26 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $223.87 | $426.58 | $630.96 |
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· 10th of 51
$457
WI $933TX $251
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.