How much rates vary
Facilitymedian $741 · 10th to 90th $398 to $1,862Professionalmedian $537 · 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 $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 $338.84 Median $478.63 Typical High $588.84 | Professional | None | $338.84 | $478.63 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,548.82 | Facility | None | $1,202.26 | $1,288.25 | $1,548.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $660.69 | Professional | None | $524.81 | $562.34 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $575.44 | Professional | None | $416.87 | $489.78 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $5,495.41 | Facility | None | $371.54 | $588.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $645.65 | Professional | None | $389.05 | $588.84 | $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 $478.63 Median $588.84 Typical High $588.84 | Facility | None | $478.63 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | None | $588.84 | $588.84 | $691.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | None | $524.81 | $524.81 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Facility | None | $275.42 | $275.42 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | None | $275.42 | $275.42 | $426.58 |
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 $331.13 Median $478.63 Typical High $676.08 | Professional | None | $331.13 | $478.63 | $676.08 |
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 $194.98 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $275.42 | $407.38 | $407.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $562.34 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $741.31 Typical High $794.33 | Professional | 63 · Small infant | $630.96 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $457.09 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $100.00 Typical High $104.71 | Professional | 80 · Assistant surgeon | $83.18 | $100.00 | $104.71 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $100.00 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $83.18 | $100.00 | $104.71 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $100.00 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $100.00 | $104.71 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $85.11 Typical High $89.13 | Professional | AS · PA/NP assist | $70.79 | $85.11 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $194.98 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $275.42 | $407.38 | $407.38 |
Where Idaho sits
The same service costs 5.8 times more in Alaska 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· 15th of 51
$562
AK $1,380UT $240
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.