How much rates vary
Facilitymedian $676 · 10th to 90th $251 to $891Professionalmedian $355 · 10th to 90th $251 to $468
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $467.74 | Professional | None | $251.19 | $467.74 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $691.83 Median $741.31 Typical High $891.25 | Facility | None | $691.83 | $741.31 | $891.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $416.87 | Professional | None | $316.23 | $371.54 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | None | $245.47 | $269.15 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $467.74 Typical High $5,495.41 | Facility | None | $162.18 | $467.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $467.74 | Professional | None | $251.19 | $467.74 | $467.74 |
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 $275.42 Median $338.84 Typical High $338.84 | Facility | None | $275.42 | $338.84 | $338.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | None | $338.84 | $338.84 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $467.74 | Professional | None | $389.05 | $416.87 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Facility | None | $162.18 | $162.18 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $295.12 | Professional | None | $162.18 | $194.98 | $295.12 |
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 $213.80 Median $295.12 Typical High $416.87 | Professional | None | $213.80 | $295.12 | $416.87 |
19 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 $123.03 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $123.03 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $50.12 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $186.21 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $37.15 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $25.12 | $46.77 | $46.77 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $281.84 | $323.59 | $346.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $38.02 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $38.02 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 62 · Two surgeons | $194.98 | $229.09 | $239.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $380.19 Median $436.52 Typical High $457.09 | Professional | 63 · Small infant | $380.19 | $436.52 | $457.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $218.78 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $57.54 Typical High $61.66 | Professional | 80 · Assistant surgeon | $50.12 | $57.54 | $61.66 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $57.54 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $50.12 | $57.54 | $61.66 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $57.54 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $57.54 | $61.66 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $48.98 Typical High $52.48 | Professional | AS · PA/NP assist | $42.66 | $48.98 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $123.03 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $50.12 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $186.21 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $37.15 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $25.12 | $46.77 | $46.77 |
Where Idaho sits
The same service costs 5.1 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· 11th of 51
$355
AK $832UT $162
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.