How much rates vary
Facilitymedian $1,549 · 10th to 90th $148 to $6,607Professionalmedian $123 · 10th to 90th $87 to $148
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 $87.10 Median $147.91 Typical High $147.91 | Professional | None | $87.10 | $147.91 | $147.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $7,413.10 | Facility | None | $1,148.15 | $2,041.74 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $147.91 | Professional | None | $114.82 | $134.90 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $128.82 | Professional | None | $93.33 | $109.65 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $147.91 Typical High $5,495.41 | Facility | None | $87.10 | $147.91 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $147.91 | Professional | None | $97.72 | $141.25 | $147.91 |
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 $107.15 Median $131.83 Typical High $131.83 | Facility | None | $107.15 | $131.83 | $131.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $223.87 | Professional | None | $131.83 | $131.83 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | None | $114.82 | $114.82 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $64.57 Typical High $4,265.80 | Facility | None | $63.10 | $64.57 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $95.50 | Professional | None | $63.10 | $63.10 | $95.50 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $154.88 | Professional | None | $75.86 | $107.15 | $154.88 |
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 $43.65 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $43.65 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $17.38 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $66.07 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $13.18 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.71 | $14.79 | $14.79 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,659.59 Median $2,818.38 Typical High $11,220.18 | Facility | 50 · Both sides | $1,659.59 | $2,818.38 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | 50 · Both sides | $177.83 | $213.80 | $251.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $131.83 | Professional | 54 · Surgery only | $107.15 | $125.89 | $131.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $14.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $141.25 Median $169.82 Typical High $177.83 | Professional | 63 · Small infant | $141.25 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $97.72 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $83.18 | $97.72 | $102.33 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $22.39 Typical High $23.44 | Professional | 80 · Assistant surgeon | $19.05 | $22.39 | $23.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $22.39 Typical High $23.44 | Professional | 81 · Minimal assistant surgeon | $19.05 | $22.39 | $23.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $22.39 Typical High $23.44 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $22.39 | $23.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $19.05 Typical High $19.95 | Professional | AS · PA/NP assist | $16.22 | $19.05 | $19.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $48.98 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $19.50 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $72.44 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $14.45 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $14.79 | $14.79 |
Where Idaho sits
The same service costs 11.2 times more in Tennessee 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· 19th of 51
$141
TN $832NY $74.13
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.