How much rates vary
Facilitymedian $676 · 10th to 90th $331 to $1,585Professionalmedian $407 · 10th to 90th $295 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 $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 $269.15 Median $380.19 Typical High $380.19 | Professional | None | $269.15 | $380.19 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,318.26 | Facility | None | $1,023.29 | $1,071.52 | $1,318.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $524.81 | Professional | None | $323.59 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $457.09 | Professional | None | $338.84 | $389.05 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $5,495.41 | Facility | None | $218.78 | $380.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $478.63 | Professional | None | $302.00 | $380.19 | $478.63 |
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 $371.54 Median $416.87 Typical High $416.87 | Facility | None | $371.54 | $416.87 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $426.58 | Professional | None | $407.38 | $416.87 | $426.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $537.03 | Professional | None | $323.59 | $323.59 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $239.88 | Facility | None | $218.78 | $218.78 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $338.84 | Professional | None | $218.78 | $218.78 | $338.84 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $562.34 | Professional | None | $281.84 | $389.05 | $562.34 |
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 $144.54 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $144.54 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $57.54 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $213.80 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $38.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $407.38 | $478.63 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $52.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $537.03 Typical High $630.96 | Professional | 63 · Small infant | $489.78 | $537.03 | $630.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $371.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $72.44 Typical High $85.11 | Professional | 80 · Assistant surgeon | $64.57 | $72.44 | $85.11 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $72.44 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $64.57 | $72.44 | $85.11 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $72.44 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $72.44 | $85.11 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $61.66 Typical High $72.44 | Professional | AS · PA/NP assist | $54.95 | $61.66 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $144.54 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $57.54 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $213.80 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $38.02 |
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· 22nd of 51
$417
AK $871TX $275
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.