How much rates vary
Facilitymedian $83 · 10th to 90th $38 to $501Professionalmedian $87 · 10th to 90th $60 to $141
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 Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $134.90 | Professional | None | $52.48 | $83.18 | $134.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $9.33 Median $56.23 Typical High $562.34 | Facility | None | $9.33 | $56.23 | $562.34 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $151.36 | Professional | None | $72.44 | $120.23 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $63.10 | Facility | None | $41.69 | $46.77 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $120.23 | Professional | None | $66.07 | $83.18 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $83.18 Typical High $134.90 | Facility | None | $54.95 | $83.18 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $138.04 | Professional | None | $54.95 | $91.20 | $138.04 |
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 $79.43 Median $79.43 Typical High $141.25 | Facility | None | $79.43 | $79.43 | $141.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $151.36 | Professional | None | $79.43 | $141.25 | $151.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $645.65 | Facility | None | $331.13 | $467.74 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $128.82 | Professional | None | $72.44 | $95.50 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $67.61 Typical High $67.61 | Facility | None | $38.02 | $67.61 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $97.72 | Professional | None | $50.12 | $67.61 | $97.72 |
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 $52.48 Median $83.18 Typical High $123.03 | Professional | None | $52.48 | $83.18 | $123.03 |
16 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 $27.54 Median $41.69 Typical High $67.61 | Professional | 52 · Reduced service | $27.54 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | 53 · Discontinued | $10.96 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.30 Typical High $20.42 | Professional | 55 · Aftercare only | $8.32 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.32 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.50 | $8.32 | $13.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $81.28 Typical High $138.04 | Professional | 54 · Surgery only | $66.07 | $81.28 | $138.04 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.91 Typical High $15.85 | Professional | 55 · Aftercare only | $7.41 | $8.91 | $15.85 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $89.13 Median $107.15 Typical High $181.97 | Professional | 63 · Small infant | $89.13 | $107.15 | $181.97 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $91.20 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $51.29 | $91.20 | $109.65 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $14.45 Typical High $24.55 | Professional | 80 · Assistant surgeon | $11.48 | $14.45 | $24.55 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $13.80 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $11.75 | $13.80 | $25.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $14.45 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $14.45 | $25.12 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $12.02 Typical High $19.50 | Professional | AS · PA/NP assist | $10.00 | $12.02 | $19.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $41.69 Typical High $67.61 | Professional | 52 · Reduced service | $27.54 | $41.69 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | 53 · Discontinued | $10.96 | $16.60 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.30 Typical High $20.42 | Professional | 55 · Aftercare only | $8.32 | $12.30 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.32 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.50 | $8.32 | $13.49 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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
$87.10
WI $204FL $66.07
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.