How much rates vary
Facilitymedian $195 · 10th to 90th $102 to $741Professionalmedian $49 · 10th to 90th $28 to $102
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 $28.18 Median $47.86 Typical High $190.55 | Professional | None | $28.18 | $47.86 | $190.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $389.05 Typical High $741.31 | Facility | None | $181.97 | $389.05 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $83.18 | Professional | None | $43.65 | $51.29 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $169.82 Typical High $229.09 | Facility | None | $151.36 | $169.82 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $181.97 | Professional | None | $70.79 | $104.71 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $37.15 Median $51.29 Typical High $5,495.41 | Facility | None | $37.15 | $51.29 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $47.86 Typical High $66.07 | Professional | None | $28.18 | $47.86 | $66.07 |
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 $83.18 Median $102.33 Typical High $102.33 | Facility | None | $83.18 | $102.33 | $102.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | None | $102.33 | $102.33 | $125.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $812.83 | Facility | None | $467.74 | $645.65 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $37.15 Median $83.18 Typical High $93.33 | Professional | None | $37.15 | $83.18 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $53.70 | Facility | None | $51.29 | $51.29 | $53.70 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $52.48 | Professional | None | $23.99 | $32.36 | $52.48 |
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 $14.13 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $14.13 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $5.62 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $36.31 Typical High $36.31 | Professional | 54 · Surgery only | $21.38 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $4.27 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.82 | $4.79 | $4.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $43.65 Typical High $45.71 | Professional | 54 · Surgery only | $38.90 | $43.65 | $45.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.79 Typical High $5.13 | Professional | 55 · Aftercare only | $4.37 | $4.79 | $5.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $52.48 Median $57.54 Typical High $61.66 | Professional | 63 · Small infant | $52.48 | $57.54 | $61.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $33.88 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $30.20 | $33.88 | $35.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.92 Median $7.76 Typical High $8.13 | Professional | 80 · Assistant surgeon | $6.92 | $7.76 | $8.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.92 Median $7.76 Typical High $8.13 | Professional | 81 · Minimal assistant surgeon | $6.92 | $7.76 | $8.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.92 Median $7.76 Typical High $8.13 | Professional | 82 · Assistant surgeon, no resident | $6.92 | $7.76 | $8.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $5.89 Median $6.61 Typical High $6.92 | Professional | AS · PA/NP assist | $5.89 | $6.61 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $14.13 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $5.62 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $36.31 Typical High $36.31 | Professional | 54 · Surgery only | $21.38 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $4.27 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.82 | $4.79 | $4.79 |
Where Idaho sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 24th of 51
$83.18
TN $288ME $31.62
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.