How much rates vary
Facilitymedian $2,344 · 10th to 90th $977 to $8,710Professionalmedian $851 · 10th to 90th $575 to $1,230
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,096.48 | Professional | None | $616.60 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $9,120.11 | Facility | None | $2,344.23 | $4,073.80 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
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 $691.83 Median $812.83 Typical High $933.25 | Professional | None | $691.83 | $812.83 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $5,495.41 | Facility | None | $676.08 | $1,096.48 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | None | $741.31 | $1,096.48 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $501.19 Typical High $588.84 | Professional | None | $30.20 | $501.19 | $588.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $794.33 Median $977.24 Typical High $977.24 | Facility | None | $794.33 | $977.24 | $977.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
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 $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $6,456.54 | Facility | None | $676.08 | $691.83 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | None | $676.08 | $676.08 | $912.01 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,778.28 | Professional | None | $758.58 | $1,230.27 | $1,778.28 |
21 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 $346.74 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $346.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $512.86 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $69.18 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $478.63 | $758.58 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $588.84 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $67.61 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $407.38 Typical High $426.58 | Professional | 62 · Two surgeons | $363.08 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $776.25 Typical High $812.83 | Professional | 63 · Small infant | $691.83 | $776.25 | $812.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $478.63 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 80 · Assistant surgeon | $93.33 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $93.33 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $89.13 Typical High $93.33 | Professional | AS · PA/NP assist | $79.43 | $89.13 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $371.54 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $147.91 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $562.34 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $112.20 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $524.81 | $758.58 | $758.58 |
Where Idaho sits
The same service costs 7.4 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· 27th of 51
$1,072
OK $3,802NY $513
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.