How much rates vary
Facilitymedian $2,239 · 10th to 90th $166 to $7,244Professionalmedian $151 · 10th to 90th $107 to $195
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 $141.25 Median $165.96 Typical High $165.96 | Facility | None | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $158.49 | Professional | None | $97.72 | $138.04 | $158.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,258.93 Median $2,570.40 Typical High $8,128.31 | Facility | None | $1,258.93 | $2,570.40 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $204.17 | Professional | None | $117.49 | $165.96 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $173.78 | Professional | None | $123.03 | $147.91 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $3,467.37 Typical High $7,762.47 | Facility | None | $120.23 | $3,467.37 | $7,762.47 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $208.93 | Professional | None | $107.15 | $154.88 | $208.93 |
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 $141.25 Median $162.18 Typical High $162.18 | Facility | None | $141.25 | $162.18 | $162.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | None | $151.36 | $162.18 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,244.36 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $194.98 | Professional | None | $117.49 | $117.49 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $4,570.88 | Facility | None | $83.18 | $85.11 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | None | $83.18 | $83.18 | $125.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $204.17 | Professional | None | $104.71 | $144.54 | $204.17 |
16 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 $53.70 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $13.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $134.90 | $154.88 | $181.97 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $15.14 | $17.38 | $20.42 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $208.93 Typical High $245.47 | Professional | 63 · Small infant | $181.97 | $208.93 | $245.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $104.71 | $120.23 | $141.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $27.54 Typical High $32.36 | Professional | 80 · Assistant surgeon | $23.99 | $27.54 | $32.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.99 Median $27.54 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $23.99 | $27.54 | $32.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.99 Median $27.54 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $23.99 | $27.54 | $32.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $23.44 Typical High $27.54 | Professional | AS · PA/NP assist | $20.42 | $23.44 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $13.80 |
Where Idaho sits
The same service costs 7.9 times more in Kansas than in New York. 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· 24th of 51
$162
KS $832NY $105
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.