How much rates vary
Facilitymedian $1,585 · 10th to 90th $316 to $6,607Professionalmedian $282 · 10th to 90th $195 to $347
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 $173.78 Median $251.19 Typical High $316.23 | Professional | None | $173.78 | $251.19 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $7,413.10 | Facility | None | $812.83 | $1,698.24 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | None | $281.84 | $316.23 | $346.74 |
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 $208.93 Median $263.03 Typical High $302.00 | Professional | None | $208.93 | $263.03 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $316.23 Typical High $5,495.41 | Facility | None | $186.21 | $316.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $346.74 | Professional | None | $208.93 | $316.23 | $346.74 |
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 $251.19 Median $309.03 Typical High $309.03 | Facility | None | $251.19 | $309.03 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $549.54 | Professional | None | $309.03 | $309.03 | $549.54 |
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 $281.84 Median $281.84 Typical High $346.74 | Professional | None | $281.84 | $281.84 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $2,238.72 | Facility | None | $147.91 | $151.36 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $229.09 | Professional | None | $147.91 | $147.91 | $229.09 |
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 $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
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 $104.71 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $41.69 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $158.49 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $147.91 | $223.87 | $223.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $295.12 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $34.67 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $34.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $398.11 Typical High $416.87 | Professional | 63 · Small infant | $331.13 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $194.98 | $229.09 | $239.88 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $52.48 Typical High $54.95 | Professional | 80 · Assistant surgeon | $44.67 | $52.48 | $54.95 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $44.67 Median $52.48 Typical High $54.95 | Professional | 81 · Minimal assistant surgeon | $44.67 | $52.48 | $54.95 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $52.48 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $52.48 | $54.95 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $44.67 Typical High $46.77 | Professional | AS · PA/NP assist | $38.02 | $44.67 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $158.49 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $147.91 | $223.87 | $223.87 |
Where Idaho sits
The same service costs 8.7 times more in Oklahoma than in Utah. 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· 17th of 51
$316
OK $1,349UT $155
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.