How much rates vary
Facilitymedian $933 · 10th to 90th $550 to $4,467Professionalmedian $245 · 10th to 90th $145 to $437
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 $141.25 Median $354.81 Typical High $354.81 | Professional | None | $141.25 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $102.33 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $20.42 | $53.70 | $53.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $4,466.84 | Facility | None | $912.01 | $1,995.26 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $457.09 | Professional | None | $218.78 | $257.04 | $457.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $426.58 | Professional | 54 · Surgery only | $199.53 | $234.42 | $426.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.70 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $25.70 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $204.17 | Professional | None | $144.54 | $173.78 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $512.86 Typical High $5,495.41 | Facility | None | $173.78 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $354.81 Typical High $354.81 | Professional | None | $173.78 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $128.82 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $25.70 | $53.70 | $53.70 |
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 $181.97 Median $223.87 Typical High $223.87 | Facility | None | $181.97 | $223.87 | $223.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,890.45 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | None | $208.93 | $245.47 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $5,128.61 | Facility | None | $2,818.38 | $3,715.35 | $5,128.61 |
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 $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $257.04 | Professional | None | $131.83 | $169.82 | $257.04 |
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 $67.61 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $67.61 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $27.54 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $13.80 | $35.48 | $35.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $323.59 Typical High $524.81 | Professional | 63 · Small infant | $275.42 | $323.59 | $524.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $154.88 | $275.42 | $323.59 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $42.66 Typical High $70.79 | Professional | 80 · Assistant surgeon | $35.48 | $42.66 | $70.79 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $57.54 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $36.31 | $57.54 | $72.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $42.66 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $42.66 | $72.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $35.48 Typical High $61.66 | Professional | AS · PA/NP assist | $33.88 | $35.48 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $85.11 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $34.67 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.38 | $35.48 | $35.48 |
Where Idaho sits
The same service costs 6.0 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
$245
AK $501KY $83.18
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.