How much rates vary
Facilitymedian $871 · 10th to 90th $282 to $3,981Professionalmedian $282 · 10th to 90th $195 to $380
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $316.23 | Professional | None | $190.55 | $269.15 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $3,981.07 | Facility | None | $537.03 | $1,071.52 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $398.11 | Professional | None | $245.47 | $309.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $288.40 | Professional | None | $199.53 | $239.88 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $316.23 Typical High $5,495.41 | Facility | None | $165.96 | $316.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $380.19 | Professional | None | $213.80 | $288.40 | $380.19 |
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 $281.84 Median $281.84 Typical High $363.08 | Facility | None | $281.84 | $281.84 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $457.09 | Professional | None | $281.84 | $363.08 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $380.19 | Professional | None | $245.47 | $288.40 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $2,089.30 | Facility | None | $173.78 | $177.83 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | None | $173.78 | $173.78 | $239.88 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $331.13 | Professional | None | $158.49 | $229.09 | $331.13 |
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 $95.50 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $38.02 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $144.54 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $28.84 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $223.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $275.42 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $275.42 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $40.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $398.11 Typical High $489.78 | Professional | 63 · Small infant | $323.59 | $398.11 | $489.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $234.42 | $281.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $48.98 Typical High $63.10 | Professional | 80 · Assistant surgeon | $41.69 | $48.98 | $63.10 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $48.98 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $41.69 | $48.98 | $57.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $53.70 Typical High $63.10 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $53.70 | $63.10 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $41.69 Typical High $52.48 | Professional | AS · PA/NP assist | $35.48 | $41.69 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $134.90 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $53.70 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $151.36 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $26.92 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $186.21 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $141.25 | $186.21 | $223.87 |
Where Idaho sits
The same service costs 4.6 times more in Alaska 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· 13th of 51
$295
AK $759UT $166
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.