How much rates vary
Facilitymedian $3,090 · 10th to 90th $646 to $11,220Professionalmedian $501 · 10th to 90th $363 to $646
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 $467.74 Median $645.65 Typical High $7,762.47 | Facility | None | $467.74 | $645.65 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $537.03 | Professional | None | $338.84 | $478.63 | $537.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,691.53 Median $4,365.16 Typical High $12,882.50 | Facility | None | $2,691.53 | $4,365.16 | $12,882.50 |
BCBS Idaho Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $588.84 | Professional | None | $478.63 | $549.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,801.89 | Facility | None | $2,511.89 | $2,818.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $537.03 | Professional | None | $398.11 | $467.74 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $10,964.78 | Facility | None | $363.08 | $645.65 | $10,964.78 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $645.65 | Professional | None | $363.08 | $537.03 | $645.65 |
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 $436.52 Median $524.81 Typical High $524.81 | Facility | None | $436.52 | $524.81 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | None | $524.81 | $524.81 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $16,218.10 | Facility | None | $8,511.38 | $11,220.18 | $16,218.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $10,000.00 | Facility | None | $251.19 | $257.04 | $10,000.00 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | None | $251.19 | $251.19 | $398.11 |
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 $346.74 Median $524.81 Typical High $724.44 | Professional | None | $346.74 | $524.81 | $724.44 |
19 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 $181.97 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $53.70 | $53.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $512.86 | $537.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $58.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $354.81 Typical High $371.54 | Professional | 62 · Two surgeons | $295.12 | $354.81 | $371.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $575.44 Median $676.08 Typical High $707.95 | Professional | 63 · Small infant | $575.44 | $676.08 | $707.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $91.20 Typical High $95.50 | Professional | 80 · Assistant surgeon | $75.86 | $91.20 | $95.50 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $91.20 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $75.86 | $91.20 | $95.50 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $75.86 Median $91.20 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $75.86 | $91.20 | $95.50 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $77.62 Typical High $81.28 | Professional | AS · PA/NP assist | $64.57 | $77.62 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $53.70 | $53.70 |
Where Idaho sits
The same service costs 10.0 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· 23rd of 51
$550
OK $2,884NY $288
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.