How much rates vary
Facilitymedian $363 · 10th to 90th $186 to $977Professionalmedian $363 · 10th to 90th $269 to $490
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 $245.47 Median $363.08 Typical High $446.68 | Professional | None | $245.47 | $363.08 | $446.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $380.19 Typical High $831.76 | Facility | None | $229.09 | $380.19 | $831.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $537.03 | Professional | None | $323.59 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $281.84 | Facility | None | $181.97 | $204.17 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $407.38 | Professional | None | $288.40 | $338.84 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $446.68 Typical High $5,495.41 | Facility | None | $234.42 | $446.68 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $501.19 | Professional | None | $269.15 | $371.54 | $501.19 |
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 $363.08 Median $363.08 Typical High $489.78 | Facility | None | $363.08 | $363.08 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $489.78 | Professional | None | $363.08 | $478.63 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $776.25 Typical High $1,047.13 | Facility | None | $549.54 | $776.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $426.58 | Professional | None | $323.59 | $398.11 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $676.08 | Facility | None | $234.42 | $239.88 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $323.59 | Professional | None | $229.09 | $234.42 | $323.59 |
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 $234.42 Median $323.59 Typical High $457.09 | Professional | None | $234.42 | $323.59 | $457.09 |
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 $123.03 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $123.03 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $48.98 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $36.31 | $44.67 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $501.19 | Professional | 54 · Surgery only | $309.03 | $363.08 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $53.70 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $245.47 Typical High $346.74 | Professional | 62 · Two surgeons | $208.93 | $245.47 | $346.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $478.63 Typical High $660.69 | Professional | 63 · Small infant | $398.11 | $478.63 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $389.05 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $64.57 Typical High $89.13 | Professional | 80 · Assistant surgeon | $53.70 | $64.57 | $89.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $77.62 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $54.95 | $77.62 | $89.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $72.44 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $72.44 | $89.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $53.70 Typical High $69.18 | Professional | AS · PA/NP assist | $45.71 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $123.03 | $181.97 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $48.98 | $72.44 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $275.42 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $54.95 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $36.31 | $44.67 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 13th of 51
$363
AK $851MD $229
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.