How much rates vary
Facilitymedian $324 · 10th to 90th $151 to $832Professionalmedian $162 · 10th to 90th $120 to $204
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 $114.82 Median $151.36 Typical High $151.36 | Professional | None | $114.82 | $151.36 | $151.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $281.84 Median $478.63 Typical High $977.24 | Facility | None | $281.84 | $478.63 | $977.24 |
BCBS Idaho Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $213.80 | Professional | None | $128.82 | $173.78 | $213.80 |
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 $134.90 Median $162.18 Typical High $186.21 | Professional | None | $134.90 | $162.18 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $151.36 Typical High $4,466.84 | Facility | None | $87.10 | $151.36 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $190.55 | Professional | None | $120.23 | $151.36 | $190.55 |
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 $147.91 Median $169.82 Typical High $169.82 | Facility | None | $147.91 | $169.82 | $169.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | None | $162.18 | $169.82 | $199.53 |
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 $128.82 Median $128.82 Typical High $213.80 | Professional | None | $128.82 | $128.82 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $89.13 Typical High $676.08 | Facility | None | $87.10 | $89.13 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $134.90 | Professional | None | $87.10 | $87.10 | $134.90 |
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 $109.65 Median $147.91 Typical High $208.93 | Professional | None | $109.65 | $147.91 | $208.93 |
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 $57.54 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $15.14 | $15.14 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $147.91 | $162.18 | $190.55 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $18.20 | $21.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $194.98 Median $218.78 Typical High $257.04 | Professional | 63 · Small infant | $194.98 | $218.78 | $257.04 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $114.82 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 80 · Assistant surgeon | $26.30 | $28.84 | $33.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $26.30 | $28.84 | $33.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $28.84 | $33.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $24.55 Typical High $28.84 | Professional | AS · PA/NP assist | $22.39 | $24.55 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $15.14 | $15.14 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$170
AK $355TX $110
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.