How much rates vary
Facilitymedian $2,138 · 10th to 90th $759 to $9,120Professionalmedian $427 · 10th to 90th $37 to $1,413
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,412.54 | Professional | None | $812.83 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $5,495.41 Typical High $10,471.29 | Facility | None | $2,344.23 | $5,495.41 | $10,471.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $302.00 | Professional | None | $37.15 | $43.65 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $380.19 | Professional | None | $181.97 | $263.03 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $1,412.54 Typical High $5,495.41 | Facility | None | $43.65 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $812.83 Typical High $1,412.54 | Professional | None | $33.88 | $812.83 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $346.74 Median $426.58 Typical High $426.58 | Facility | None | $346.74 | $426.58 | $426.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | None | $426.58 | $426.58 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $870.96 | Professional | None | $302.00 | $302.00 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Facility | None | $43.65 | $43.65 | $45.71 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | None | $36.31 | $43.65 | $43.65 |
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 $537.03 Median $912.01 Typical High $1,380.38 | Professional | None | $537.03 | $912.01 | $1,380.38 |
18 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 $407.38 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $407.38 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $162.18 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $602.56 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $120.23 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $81.28 | $141.25 | $141.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 54 · Surgery only | $33.11 | $37.15 | $38.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 55 · Aftercare only | $3.72 | $4.07 | $4.37 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 63 · Small infant | $44.67 | $48.98 | $52.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.70 Median $28.84 Typical High $30.20 | Professional | 78 · Unplanned return to OR | $25.70 | $28.84 | $30.20 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.89 Median $6.61 Typical High $6.92 | Professional | 80 · Assistant surgeon | $5.89 | $6.61 | $6.92 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.89 Median $6.61 Typical High $6.92 | Professional | 81 · Minimal assistant surgeon | $5.89 | $6.61 | $6.92 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.89 Median $6.61 Typical High $6.92 | Professional | 82 · Assistant surgeon, no resident | $5.89 | $6.61 | $6.92 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $5.62 Typical High $5.89 | Professional | AS · PA/NP assist | $5.01 | $5.62 | $5.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $407.38 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $162.18 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $123.03 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $81.28 | $141.25 | $141.25 |
Where Idaho sits
The same service costs 53.7 times more in Alaska 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· 18th of 51
$977
AK $2,692NY $50.12
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.