How much rates vary
Facilitymedian $2,344 · 10th to 90th $257 to $7,943Professionalmedian $195 · 10th to 90th $141 to $251
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $181.97 | Professional | None | $128.82 | $177.83 | $181.97 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,454.71 Typical High $8,128.31 | Facility | None | $1,412.54 | $2,454.71 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $263.03 | Professional | None | $154.88 | $213.80 | $263.03 |
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 $158.49 Median $186.21 Typical High $218.78 | Professional | None | $158.49 | $186.21 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $5,495.41 | Facility | None | $144.54 | $177.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $245.47 | Professional | None | $144.54 | $181.97 | $245.47 |
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 $181.97 Median $208.93 Typical High $208.93 | Facility | None | $181.97 | $208.93 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $245.47 | Professional | None | $194.98 | $208.93 | $245.47 |
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 $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $5,128.61 | Facility | None | $107.15 | $109.65 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | None | $107.15 | $107.15 | $162.18 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $257.04 | Professional | None | $134.90 | $186.21 | $257.04 |
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 $69.18 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $199.53 | $234.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $22.39 | $26.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $234.42 Median $269.15 Typical High $316.23 | Professional | 63 · Small infant | $234.42 | $269.15 | $316.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $181.97 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $35.48 Typical High $41.69 | Professional | 80 · Assistant surgeon | $31.62 | $35.48 | $41.69 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $35.48 Typical High $41.69 | Professional | 81 · Minimal assistant surgeon | $31.62 | $35.48 | $41.69 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $35.48 Typical High $41.69 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $35.48 | $41.69 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $30.20 Typical High $35.48 | Professional | AS · PA/NP assist | $26.92 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $104.71 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
Where Idaho sits
The same service costs 10.7 times more in Oklahoma 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· 25th of 51
$209
OK $1,413NY $132
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.