How much rates vary
Facilitymedian $631 · 10th to 90th $204 to $7,079Professionalmedian $324 · 10th to 90th $200 to $490
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 $204.17 Median $416.87 Typical High $676.08 | Professional | None | $204.17 | $416.87 | $676.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $208.93 Median $1,348.96 Typical High $8,317.64 | Facility | None | $208.93 | $1,348.96 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $489.78 | Professional | None | $239.88 | $309.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $275.42 | Facility | None | $181.97 | $204.17 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $371.54 | Professional | None | $199.53 | $263.03 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $588.84 Typical High $4,466.84 | Facility | None | $162.18 | $588.84 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $416.87 Typical High $676.08 | Professional | None | $213.80 | $416.87 | $676.08 |
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 $251.19 Median $251.19 Typical High $446.68 | Facility | None | $251.19 | $251.19 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $457.09 | Professional | None | $251.19 | $275.42 | $457.09 |
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 $275.42 Median $323.59 Typical High $457.09 | Professional | None | $275.42 | $323.59 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $4,897.79 | Facility | None | $213.80 | $218.78 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $281.84 | Professional | None | $158.49 | $213.80 | $281.84 |
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 $158.49 Median $257.04 Typical High $426.58 | Professional | None | $158.49 | $257.04 | $426.58 |
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 $100.00 Median $208.93 Typical High $338.84 | Professional | 52 · Reduced service | $100.00 | $208.93 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $83.18 Typical High $134.90 | Professional | 53 · Discontinued | $40.74 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $309.03 Typical High $512.86 | Professional | 54 · Surgery only | $151.36 | $309.03 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $63.10 Typical High $102.33 | Professional | 55 · Aftercare only | $30.20 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $41.69 Typical High $67.61 | Professional | 56 · Pre-op care only | $20.42 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $288.40 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $141.25 | $288.40 | $478.63 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $213.80 | $371.54 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $48.98 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $48.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $501.19 Typical High $588.84 | Professional | 63 · Small infant | $281.84 | $501.19 | $588.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $169.82 | $295.12 | $346.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $45.71 Typical High $79.43 | Professional | 80 · Assistant surgeon | $37.15 | $45.71 | $79.43 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.02 Median $69.18 Typical High $79.43 | Professional | 81 · Minimal assistant surgeon | $38.02 | $69.18 | $79.43 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $45.71 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $45.71 | $77.62 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $58.88 Typical High $66.07 | Professional | AS · PA/NP assist | $31.62 | $58.88 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $208.93 Typical High $338.84 | Professional | 52 · Reduced service | $100.00 | $208.93 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $83.18 Typical High $134.90 | Professional | 53 · Discontinued | $40.74 | $83.18 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $309.03 Typical High $512.86 | Professional | 54 · Surgery only | $151.36 | $309.03 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $63.10 Typical High $102.33 | Professional | 55 · Aftercare only | $30.20 | $63.10 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $41.69 Typical High $67.61 | Professional | 56 · Pre-op care only | $20.42 | $41.69 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $288.40 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $141.25 | $288.40 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $309.03 | Professional | 54 · Surgery only | $194.98 | $194.98 | $309.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $44.67 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $331.13 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$324
AK $575NJ $166
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.