How much rates vary
Facilitymedian $3,388 · 10th to 90th $759 to $12,303Professionalmedian $562 · 10th to 90th $427 to $813
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 $446.68 Median $812.83 Typical High $812.83 | Professional | None | $446.68 | $812.83 | $812.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $13,489.63 | Facility | None | $2,089.30 | $3,630.78 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $691.83 | Professional | None | $537.03 | $630.96 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $4,570.88 | Facility | None | $3,019.95 | $3,388.44 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $616.60 | Professional | None | $446.68 | $512.86 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $812.83 Typical High $5,495.41 | Facility | None | $416.87 | $812.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $812.83 | Professional | None | $446.68 | $676.08 | $812.83 |
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 $501.19 Median $616.60 Typical High $616.60 | Facility | None | $501.19 | $616.60 | $616.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,071.52 | Professional | None | $616.60 | $616.60 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,982.44 | Facility | None | $8,511.38 | $12,302.69 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $676.08 | Professional | None | $537.03 | $537.03 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $6,760.83 | Facility | None | $295.12 | $295.12 | $6,760.83 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $446.68 | Professional | None | $295.12 | $295.12 | $446.68 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $758.58 | Professional | None | $371.54 | $512.86 | $758.58 |
20 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 $223.87 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $223.87 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $89.13 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $331.13 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $67.61 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $44.67 | $81.28 | $81.28 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $5,248.07 Typical High $20,417.38 | Facility | 50 · Both sides | $2,951.21 | $5,248.07 | $20,417.38 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $1,202.26 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $588.84 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $69.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $776.25 Typical High $831.76 | Professional | 63 · Small infant | $660.69 | $776.25 | $831.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $478.63 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $109.65 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $104.71 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $89.13 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $104.71 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $89.13 Typical High $93.33 | Professional | AS · PA/NP assist | $74.13 | $89.13 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $223.87 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $89.13 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $338.84 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $67.61 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $44.67 | $81.28 | $81.28 |
Where Idaho sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 16th of 51
$676
OK $2,630NY $339
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.