How much rates vary
Facilitymedian $1,862 · 10th to 90th $575 to $7,244Professionalmedian $832 · 10th to 90th $501 to $1,318
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 $501.19 Median $1,318.26 Typical High $1,318.26 | Professional | None | $501.19 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $371.54 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $346.74 | $933.25 | $933.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $8,317.64 | Facility | None | $1,202.26 | $2,089.30 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $933.25 | Professional | None | $776.25 | $891.25 | $933.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $794.33 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $616.60 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $758.58 | Professional | None | $501.19 | $630.96 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $5,495.41 | Facility | None | $398.11 | $1,318.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,318.26 | Professional | None | $676.08 | $870.96 | $1,318.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $501.19 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $467.74 | $933.25 | $933.25 |
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 $676.08 Median $831.76 Typical High $831.76 | Facility | None | $676.08 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | None | $831.76 | $831.76 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | None | $776.25 | $912.01 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $4,897.79 | Facility | None | $398.11 | $407.38 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $851.14 | Professional | None | $398.11 | $398.11 | $851.14 |
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 $467.74 Median $602.56 Typical High $912.01 | Professional | None | $467.74 | $602.56 | $912.01 |
17 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 $245.47 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $245.47 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $100.00 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $74.13 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $50.12 | $131.83 | $131.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,071.52 Typical High $1,122.02 | Professional | 63 · Small infant | $933.25 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 80 · Assistant surgeon | $123.03 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $123.03 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | AS · PA/NP assist | $104.71 | $120.23 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $338.84 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $134.90 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $100.00 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $67.61 | $131.83 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 22 · Increased work | $977.24 | $977.24 | $977.24 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 63 · Small infant | $977.24 | $977.24 | $977.24 |
Where Idaho sits
The same service costs 6.2 times more in Alaska 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· 8th of 51
$871
AK $1,862TX $302
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.