How much rates vary
Facilitymedian $302 · 10th to 90th $174 to $832Professionalmedian $295 · 10th to 90th $219 to $372
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | None | $208.93 | $269.15 | $269.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $354.81 Typical High $831.76 | Facility | None | $229.09 | $354.81 | $831.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $389.05 | Professional | None | $234.42 | $316.23 | $389.05 |
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 $245.47 Median $288.40 Typical High $331.13 | Professional | None | $245.47 | $288.40 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $4,466.84 | Facility | None | $154.88 | $269.15 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $346.74 | Professional | None | $218.78 | $269.15 | $346.74 |
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 $269.15 Median $309.03 Typical High $309.03 | Facility | None | $269.15 | $309.03 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $363.08 | Professional | None | $295.12 | $309.03 | $363.08 |
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 $234.42 Median $234.42 Typical High $389.05 | Professional | None | $234.42 | $234.42 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $549.54 | Facility | None | $158.49 | $162.18 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | None | $158.49 | $158.49 | $245.47 |
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 $204.17 Median $288.40 Typical High $407.38 | Professional | None | $204.17 | $288.40 | $407.38 |
18 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 $104.71 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $26.92 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $295.12 | $346.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $38.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $354.81 Median $398.11 Typical High $467.74 | Professional | 63 · Small infant | $354.81 | $398.11 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $269.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $52.48 Typical High $61.66 | Professional | 80 · Assistant surgeon | $46.77 | $52.48 | $61.66 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $46.77 Median $52.48 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $46.77 | $52.48 | $61.66 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $46.77 Median $52.48 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $46.77 | $52.48 | $61.66 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $44.67 Typical High $52.48 | Professional | AS · PA/NP assist | $39.81 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $26.92 |
Where Idaho sits
The same service costs 3.2 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· 18th of 51
$295
AK $631UT $195
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.