How much rates vary
Facilitymedian $631 · 10th to 90th $182 to $1,862Professionalmedian $269 · 10th to 90th $151 to $447
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 $245.47 Median $446.68 Typical High $537.03 | Professional | None | $245.47 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $186.21 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $37.15 | $66.07 | $66.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $302.00 | Professional | None | $151.36 | $177.83 | $302.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 54 · Surgery only | $138.04 | $154.88 | $162.18 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $15.14 | $16.98 | $17.78 |
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 $234.42 Median $295.12 Typical High $316.23 | Professional | None | $234.42 | $295.12 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $446.68 Typical High $5,495.41 | Facility | None | $147.91 | $446.68 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $446.68 | Professional | None | $194.98 | $245.47 | $446.68 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $186.21 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $37.15 | $66.07 | $66.07 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $131.83 Typical High $154.88 | Professional | None | $30.20 | $131.83 | $154.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $302.00 Median $371.54 Typical High $371.54 | Facility | None | $302.00 | $371.54 | $371.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $323.59 | Professional | None | $302.00 | $302.00 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Facility | None | $177.83 | $177.83 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $257.04 | Professional | None | $177.83 | $177.83 | $257.04 |
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 $169.82 Median $269.15 Typical High $398.11 | Professional | None | $169.82 | $269.15 | $398.11 |
9 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 $24.55 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $44.67 | $44.67 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $95.50 Median $107.15 Typical High $112.20 | Professional | 62 · Two surgeons | $95.50 | $107.15 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $204.17 Typical High $213.80 | Professional | 63 · Small infant | $181.97 | $204.17 | $213.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $120.23 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $107.15 | $120.23 | $125.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $27.54 Typical High $28.84 | Professional | 80 · Assistant surgeon | $24.55 | $27.54 | $28.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $27.54 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $24.55 | $27.54 | $28.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $27.54 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $27.54 | $28.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $23.44 Typical High $24.55 | Professional | AS · PA/NP assist | $20.89 | $23.44 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $44.67 | $44.67 |
Where Idaho sits
The same service costs 10.5 times more in North Dakota 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· 32nd of 51
$302
ND $2,239KY $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.