How much rates vary
Facilitymedian $676 · 10th to 90th $437 to $1,862Professionalmedian $661 · 10th to 90th $437 to $1,096
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,096.48 Typical High $1,096.48 | Professional | None | $436.52 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $323.59 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $64.57 | $162.18 | $162.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,778.28 | Facility | None | $1,380.38 | $1,479.11 | $1,778.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $758.58 | Professional | None | $602.56 | $707.95 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $616.60 | $645.65 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $630.96 | Professional | None | $467.74 | $537.03 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $1,096.48 Typical High $5,495.41 | Facility | None | $309.03 | $1,096.48 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,096.48 | Professional | None | $512.86 | $707.95 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $380.19 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $75.86 | $162.18 | $162.18 |
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 $524.81 Median $645.65 Typical High $645.65 | Facility | None | $524.81 | $645.65 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $724.44 | Professional | None | $645.65 | $645.65 | $724.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Facility | None | $309.03 | $309.03 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $691.83 | Professional | None | $309.03 | $309.03 | $691.83 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $831.76 | Professional | None | $407.38 | $537.03 | $831.76 |
14 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 56 · Pre-op care only Typical Low $43.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $43.65 | $109.65 | $109.65 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $426.58 Typical High $457.09 | Professional | 62 · Two surgeons | $371.54 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | 63 · Small infant | $707.95 | $831.76 | $870.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $109.65 Typical High $114.82 | Professional | 80 · Assistant surgeon | $95.50 | $109.65 | $114.82 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $109.65 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $95.50 | $109.65 | $114.82 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $109.65 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $109.65 | $114.82 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $93.33 Typical High $97.72 | Professional | AS · PA/NP assist | $81.28 | $93.33 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $51.29 | $109.65 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 22 · Increased work | $794.33 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 62 · Two surgeons | $446.68 | $446.68 | $446.68 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 63 · Small infant | $794.33 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Where Idaho sits
The same service costs 4.4 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· 11th of 51
$661
AK $1,514NJ $347
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.