How much rates vary
Facilitymedian $195 · 10th to 90th $56 to $776Professionalmedian $174 · 10th to 90th $95 to $214
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 Professional Modifier None (both parts) Typical Low $93.33 Median $173.78 Typical High $190.55 | Professional | None (both parts) | $93.33 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $74.13 Typical High $104.71 | Professional | 26 · Professional part | $44.67 | $74.13 | $104.71 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $46.77 Median $87.10 Typical High $95.50 | Professional | TC · Technical part | $46.77 | $87.10 | $95.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $56.23 Median $323.59 Typical High $776.25 | Facility | None | $56.23 | $323.59 | $776.25 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $165.96 Median $186.21 Typical High $218.78 | Professional | None (both parts) | $165.96 | $186.21 | $218.78 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $81.28 Median $91.20 Typical High $102.33 | Professional | 26 · Professional part | $81.28 | $91.20 | $102.33 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $97.72 Typical High $117.49 | Professional | TC · Technical part | $79.43 | $97.72 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $91.20 | Facility | None | $60.26 | $67.61 | $91.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $97.72 Median $123.03 Typical High $134.90 | Professional | None (both parts) | $97.72 | $123.03 | $134.90 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $69.18 Typical High $75.86 | Professional | 26 · Professional part | $54.95 | $69.18 | $75.86 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | TC · Technical part | $43.65 | $54.95 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $190.55 Typical High $275.42 | Facility | None | $93.33 | $190.55 | $275.42 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $104.71 Median $190.55 Typical High $208.93 | Professional | None (both parts) | $104.71 | $190.55 | $208.93 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $87.10 Typical High $120.23 | Professional | 26 · Professional part | $54.95 | $87.10 | $120.23 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $87.10 Typical High $97.72 | Professional | TC · Technical part | $50.12 | $87.10 | $97.72 |
Molina Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $158.49 Median $194.98 Typical High $194.98 | Facility | None | $158.49 | $194.98 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $269.15 | Professional | None (both parts) | $194.98 | $194.98 | $269.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $977.24 | Facility | None | $524.81 | $758.58 | $977.24 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $141.25 Median $173.78 Typical High $194.98 | Professional | None (both parts) | $141.25 | $173.78 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $575.44 | Facility | None | $93.33 | $95.50 | $575.44 |
Select Health Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | None (both parts) | $93.33 | $93.33 | $128.82 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None (both parts) Typical Low $87.10 Median $123.03 Typical High $173.78 | Professional | None (both parts) | $87.10 | $123.03 | $173.78 |
United Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $66.07 Typical High $97.72 | Professional | 26 · Professional part | $45.71 | $66.07 | $97.72 |
United Setting Professional Modifier TC · Technical part Typical Low $37.15 Median $56.23 Typical High $83.18 | Professional | TC · Technical part | $37.15 | $56.23 | $83.18 |
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 $52.48 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $52.48 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $20.89 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $15.49 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.47 | $19.05 | $19.05 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $141.25 | $181.97 | $199.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $21.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $239.88 Typical High $263.03 | Professional | 63 · Small infant | $190.55 | $239.88 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $154.88 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $32.36 Typical High $35.48 | Professional | 80 · Assistant surgeon | $25.12 | $32.36 | $35.48 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $32.36 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $25.12 | $32.36 | $35.48 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $32.36 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $32.36 | $35.48 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $27.54 Typical High $29.51 | Professional | AS · PA/NP assist | $21.38 | $27.54 | $29.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $52.48 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $20.89 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $15.85 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.47 | $19.05 | $19.05 |
Where Idaho sits
The same service costs 5.9 times more in Alaska than in Alabama. 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· 9th of 51
$174
AK $331AL $56.23
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.