How much rates vary
Facilitymedian $692 · 10th to 90th $355 to $3,981Professionalmedian $490 · 10th to 90th $275 to $794
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 $575.44 Typical High $1,023.29 | Professional | None | $281.84 | $575.44 | $1,023.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $354.81 Median $1,412.54 Typical High $3,981.07 | Facility | None | $354.81 | $1,412.54 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $794.33 | Professional | None | $346.74 | $501.19 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $354.81 Typical High $489.78 | Facility | None | $316.23 | $354.81 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $562.34 | Professional | None | $275.42 | $346.74 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $831.76 Typical High $5,495.41 | Facility | None | $194.98 | $831.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $1,023.29 | Professional | None | $309.03 | $575.44 | $1,023.29 |
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 $363.08 Median $363.08 Typical High $741.31 | Facility | None | $363.08 | $363.08 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $741.31 | Professional | None | $363.08 | $436.52 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $707.95 | Professional | None | $380.19 | $478.63 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $2,691.53 | Facility | None | $354.81 | $354.81 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $446.68 | Professional | None | $234.42 | $354.81 | $446.68 |
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 $218.78 Median $354.81 Typical High $575.44 | Professional | None | $218.78 | $354.81 | $575.44 |
23 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 $141.25 Median $288.40 Typical High $512.86 | Professional | 52 · Reduced service | $141.25 | $288.40 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $114.82 Typical High $204.17 | Professional | 53 · Discontinued | $56.23 | $114.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $436.52 Typical High $776.25 | Professional | 54 · Surgery only | $208.93 | $436.52 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $87.10 Typical High $154.88 | Professional | 55 · Aftercare only | $41.69 | $87.10 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $102.33 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $407.38 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $194.98 | $407.38 | $724.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $724.44 | Professional | 54 · Surgery only | $309.03 | $354.81 | $724.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $79.43 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $79.43 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $478.63 Typical High $933.25 | Professional | 63 · Small infant | $398.11 | $478.63 | $933.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $575.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $109.65 Typical High $128.82 | Professional | 80 · Assistant surgeon | $54.95 | $109.65 | $128.82 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $109.65 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $61.66 | $109.65 | $128.82 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $64.57 Typical High $123.03 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $64.57 | $123.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $54.95 Typical High $109.65 | Professional | AS · PA/NP assist | $51.29 | $54.95 | $109.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $288.40 Typical High $512.86 | Professional | 52 · Reduced service | $141.25 | $288.40 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $114.82 Typical High $204.17 | Professional | 53 · Discontinued | $56.23 | $114.82 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $436.52 Typical High $776.25 | Professional | 54 · Surgery only | $208.93 | $436.52 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $87.10 Typical High $154.88 | Professional | 55 · Aftercare only | $41.69 | $87.10 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $102.33 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $407.38 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $194.98 | $407.38 | $724.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $478.63 | Professional | 54 · Surgery only | $275.42 | $275.42 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $69.18 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $69.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $512.86 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$490
AK $813KY $234
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.