How much rates vary
Facilitymedian $661 · 10th to 90th $295 to $2,455Professionalmedian $251 · 10th to 90th $162 to $468
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 $147.91 Median $251.19 Typical High $251.19 | Professional | None | $147.91 | $251.19 | $251.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $2,454.71 | Facility | None | $331.13 | $660.69 | $2,454.71 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $501.19 | Professional | None | $223.87 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $616.60 Typical High $851.14 | Facility | None | $549.54 | $616.60 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $245.47 | Professional | None | $181.97 | $213.80 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $354.81 Typical High $5,495.41 | Facility | None | $173.78 | $354.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $794.33 | Professional | None | $154.88 | $251.19 | $794.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $251.19 | Facility | None | $208.93 | $251.19 | $251.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $309.03 | Professional | None | $251.19 | $251.19 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,630.27 | Facility | None | $1,230.27 | $1,819.70 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | None | $223.87 | $223.87 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $1,905.46 | Facility | None | $575.44 | $794.33 | $1,905.46 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $281.84 | Professional | None | $141.25 | $194.98 | $281.84 |
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 $85.11 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $25.12 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $288.40 | $380.19 | $467.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $30.90 | $37.15 | $50.12 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $229.09 Typical High $309.03 | Professional | 62 · Two surgeons | $194.98 | $229.09 | $309.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $371.54 Median $436.52 Typical High $616.60 | Professional | 63 · Small infant | $371.54 | $436.52 | $616.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $263.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $213.80 | $263.03 | $346.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $57.54 Typical High $77.62 | Professional | 80 · Assistant surgeon | $48.98 | $57.54 | $77.62 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $57.54 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $47.86 | $57.54 | $83.18 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $48.98 Median $57.54 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $48.98 | $57.54 | $77.62 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $48.98 Typical High $69.18 | Professional | AS · PA/NP assist | $41.69 | $48.98 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $25.12 |
Where Idaho sits
The same service costs 4.3 times more in Alaska 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· 18th of 51
$295
AK $603NY $141
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.