How much rates vary
Facilitymedian $229 · 10th to 90th $26 to $501Professionalmedian $74 · 10th to 90th $52 to $107
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 $75.86 Median $79.43 Typical High $309.03 | Facility | None | $75.86 | $79.43 | $309.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $66.07 Typical High $79.43 | Professional | None (both parts) | $50.12 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $39.81 Typical High $44.67 | Professional | 26 · Professional part | $28.84 | $39.81 | $44.67 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $19.50 Median $26.30 Typical High $31.62 | Professional | TC · Technical part | $19.50 | $26.30 | $31.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $26.92 Median $234.42 Typical High $512.86 | Facility | None | $26.92 | $234.42 | $512.86 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $56.23 Median $91.20 Typical High $112.20 | Professional | None (both parts) | $56.23 | $91.20 | $112.20 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $53.70 Typical High $64.57 | Professional | 26 · Professional part | $33.11 | $53.70 | $64.57 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $38.90 Typical High $46.77 | Professional | TC · Technical part | $23.44 | $38.90 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $25.70 Typical High $37.15 | Facility | None | $22.91 | $25.70 | $37.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $72.44 Typical High $81.28 | Professional | None (both parts) | $58.88 | $72.44 | $81.28 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $45.71 Typical High $50.12 | Professional | 26 · Professional part | $36.31 | $45.71 | $50.12 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $29.51 Typical High $31.62 | Professional | TC · Technical part | $23.44 | $29.51 | $31.62 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $295.12 Typical High $501.19 | Facility | None | $66.07 | $295.12 | $501.19 |
Moda Health Setting Facility Modifier TC · Technical part Typical Low $31.62 Median $426.58 Typical High $537.03 | Facility | TC · Technical part | $31.62 | $426.58 | $537.03 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $52.48 Median $75.86 Typical High $186.21 | Professional | None (both parts) | $52.48 | $75.86 | $186.21 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $43.65 Typical High $104.71 | Professional | 26 · Professional part | $26.92 | $43.65 | $104.71 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $22.39 Median $26.30 Typical High $38.90 | Professional | TC · Technical part | $22.39 | $26.30 | $38.90 |
Molina Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $89.13 | Facility | None | $77.62 | $89.13 | $89.13 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $74.13 Median $89.13 Typical High $109.65 | Professional | None (both parts) | $74.13 | $89.13 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $645.65 | Facility | None | $331.13 | $467.74 | $645.65 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | None (both parts) | $56.23 | $56.23 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $45.71 Median $46.77 Typical High $426.58 | Facility | None | $45.71 | $46.77 | $426.58 |
Select Health Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | None (both parts) | $45.71 | $45.71 | $61.66 |
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 (both parts) Typical Low $46.77 Median $66.07 Typical High $93.33 | Professional | None (both parts) | $46.77 | $66.07 | $93.33 |
United Setting Professional Modifier 26 · Professional part Typical Low $30.90 Median $42.66 Typical High $58.88 | Professional | 26 · Professional part | $30.90 | $42.66 | $58.88 |
United Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $25.70 Typical High $33.88 | Professional | TC · Technical part | $15.14 | $25.70 | $33.88 |
12 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 $26.30 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $26.30 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.72 | $13.18 | $13.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $66.07 | $85.11 | $100.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.55 Typical High $11.22 | Professional | 55 · Aftercare only | $7.41 | $9.55 | $11.22 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $87.10 Median $114.82 Typical High $134.90 | Professional | 63 · Small infant | $87.10 | $114.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $66.07 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $51.29 | $66.07 | $77.62 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.75 Median $15.14 Typical High $17.78 | Professional | 80 · Assistant surgeon | $11.75 | $15.14 | $17.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $15.14 Typical High $17.78 | Professional | 81 · Minimal assistant surgeon | $11.75 | $15.14 | $17.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $15.14 Typical High $17.78 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $15.14 | $17.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $12.88 Typical High $15.14 | Professional | AS · PA/NP assist | $10.00 | $12.88 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $26.30 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.72 | $13.18 | $13.18 |
Where Idaho sits
The same service costs 6.5 times more in Minnesota than in Kentucky. 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· 12th of 51
$79.43
MN $295KY $45.71
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.