How much rates vary
Facilitymedian $1,905 · 10th to 90th $759 to $7,586Professionalmedian $398 · 10th to 90th $224 to $708
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 $281.84 Median $707.95 Typical High $707.95 | Professional | None | $281.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $204.17 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $40.74 | $107.15 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $660.69 Median $1,949.84 Typical High $8,317.64 | Facility | None | $660.69 | $1,949.84 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $489.78 | Professional | None | $204.17 | $389.05 | $489.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $398.11 | Professional | 54 · Surgery only | $177.83 | $208.93 | $398.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $20.42 | $38.90 | $45.71 |
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 $288.40 Median $346.74 Typical High $407.38 | Professional | None | $288.40 | $346.74 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $5,495.41 | Facility | None | $346.74 | $1,023.29 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $707.95 Typical High $707.95 | Professional | None | $346.74 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $257.04 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $51.29 | $107.15 | $107.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $446.68 | Facility | None | $363.08 | $446.68 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $416.87 Median $489.78 Typical High $501.19 | Professional | None | $416.87 | $489.78 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $4,897.79 Typical High $7,585.78 | Facility | None | $3,548.13 | $4,897.79 | $7,585.78 |
Select Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $512.86 | Professional | None | $263.03 | $338.84 | $512.86 |
12 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 $138.04 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $138.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $54.95 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $27.54 | $70.79 | $70.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $288.40 Typical High $549.54 | Professional | 63 · Small infant | $245.47 | $288.40 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $165.96 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $141.25 | $165.96 | $316.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $38.90 Typical High $69.18 | Professional | 80 · Assistant surgeon | $33.11 | $38.90 | $69.18 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $38.90 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $31.62 | $38.90 | $72.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $37.15 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $37.15 | $70.79 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $31.62 Typical High $61.66 | Professional | AS · PA/NP assist | $26.92 | $31.62 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $173.78 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $69.18 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $34.67 | $70.79 | $70.79 |
Where Idaho sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$427
AK $1,000FL $219
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.