How much rates vary
Facilitymedian $724 · 10th to 90th $407 to $2,512Professionalmedian $661 · 10th to 90th $501 to $871
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $630.96 | Professional | None | $489.78 | $630.96 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $2,238.72 | Facility | None | $851.14 | $1,698.24 | $2,238.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $912.01 | Professional | None | $537.03 | $741.31 | $912.01 |
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 $549.54 Median $660.69 Typical High $758.58 | Professional | None | $549.54 | $660.69 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $5,495.41 | Facility | None | $478.63 | $630.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $812.83 | Professional | None | $512.86 | $630.96 | $812.83 |
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 $630.96 Median $724.44 Typical High $724.44 | Facility | None | $630.96 | $724.44 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | None | $691.83 | $724.44 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $891.25 | Professional | None | $537.03 | $537.03 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $407.38 | Facility | None | $371.54 | $371.54 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $575.44 | Professional | None | $371.54 | $371.54 | $575.44 |
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 $446.68 Median $602.56 Typical High $870.96 | Professional | None | $446.68 | $602.56 | $870.96 |
20 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 $245.47 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $245.47 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $74.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $446.68 | $446.68 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $616.60 | $691.83 | $812.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $77.62 | $91.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $831.76 Median $933.25 Typical High $1,096.48 | Professional | 63 · Small infant | $831.76 | $933.25 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $630.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | 80 · Assistant surgeon | $109.65 | $123.03 | $144.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $109.65 | $123.03 | $144.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $123.03 | $144.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $104.71 Typical High $123.03 | Professional | AS · PA/NP assist | $93.33 | $104.71 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $245.47 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $74.13 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $446.68 | $446.68 |
Where Idaho sits
The same service costs 7.2 times more in Oklahoma 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
$676
OK $2,042UT $282
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.