How much rates vary
Facilitymedian $1,778 · 10th to 90th $550 to $6,310Professionalmedian $525 · 10th to 90th $295 to $776
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 $295.12 Median $776.25 Typical High $776.25 | Professional | None | $295.12 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $218.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $204.17 | $549.54 | $549.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $7,244.36 | Facility | None | $1,096.48 | $1,949.84 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $616.60 | Professional | None | $512.86 | $549.54 | $616.60 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $512.86 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,398.83 | Facility | None | $1,584.89 | $1,778.28 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $446.68 | Professional | None | $309.03 | $380.19 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $776.25 Typical High $5,495.41 | Facility | None | $263.03 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $776.25 | Professional | None | $389.05 | $512.86 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $288.40 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $269.15 | $549.54 | $549.54 |
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 $446.68 Median $549.54 Typical High $549.54 | Facility | None | $446.68 | $549.54 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | None | $524.81 | $549.54 | $549.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $363.08 | $363.08 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $6,309.57 Typical High $9,120.11 | Facility | None | $4,073.80 | $6,309.57 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | None | $467.74 | $549.54 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $5,011.87 | Facility | None | $263.03 | $269.15 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $501.19 | Professional | None | $263.03 | $263.03 | $501.19 |
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 $251.19 Median $346.74 Typical High $512.86 | Professional | None | $251.19 | $346.74 | $512.86 |
17 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 $144.54 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $144.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $57.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $43.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $28.84 | $77.62 | $77.62 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $61.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $616.60 Median $676.08 Typical High $741.31 | Professional | 63 · Small infant | $616.60 | $676.08 | $741.31 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $91.20 Typical High $100.00 | Professional | 80 · Assistant surgeon | $81.28 | $91.20 | $100.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $81.28 Median $91.20 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $81.28 | $91.20 | $100.00 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $81.28 Median $91.20 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $81.28 | $91.20 | $100.00 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $77.62 Typical High $85.11 | Professional | AS · PA/NP assist | $69.18 | $77.62 | $85.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $194.98 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $77.62 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $58.88 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $38.90 | $77.62 | $77.62 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 22 · Increased work | $575.44 | $575.44 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 63 · Small infant | $575.44 | $575.44 | $575.44 |
Where Idaho sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 7th of 51
$550
AK $1,122TX $214
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.