How much rates vary
Facilitymedian $200 · 10th to 90th $65 to $776Professionalmedian $110 · 10th to 90th $65 to $195
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 $54.95 Median $109.65 Typical High $199.53 | Professional | None | $54.95 | $109.65 | $199.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $70.79 Median $380.19 Typical High $776.25 | Facility | None | $70.79 | $380.19 | $776.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $169.82 | Professional | None | $69.18 | $117.49 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $87.10 | Facility | None | $57.54 | $64.57 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $123.03 | Professional | None | $61.66 | $85.11 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $154.88 Typical High $5,495.41 | Facility | None | $54.95 | $154.88 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $199.53 | Professional | None | $64.57 | $109.65 | $199.53 |
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 $75.86 Median $75.86 Typical High $154.88 | Facility | None | $75.86 | $75.86 | $154.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $194.98 | Professional | None | $75.86 | $109.65 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $977.24 | Facility | None | $501.19 | $724.44 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $194.98 | Professional | None | $89.13 | $112.20 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $616.60 | Facility | None | $74.13 | $75.86 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $102.33 | Professional | None | $44.67 | $69.18 | $102.33 |
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 Typical Low $53.70 Median $102.33 Typical High $169.82 | Professional | None | $53.70 | $102.33 | $169.82 |
24 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 $26.92 Median $54.95 Typical High $100.00 | Professional | 52 · Reduced service | $26.92 | $54.95 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $21.88 Typical High $39.81 | Professional | 53 · Discontinued | $10.96 | $21.88 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $81.28 Typical High $147.91 | Professional | 54 · Surgery only | $40.74 | $81.28 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $16.22 Typical High $29.51 | Professional | 55 · Aftercare only | $8.13 | $16.22 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $10.96 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.50 | $10.96 | $19.95 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $107.15 Median $524.81 Typical High $1,148.15 | Facility | 50 · Both sides | $107.15 | $524.81 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $165.96 Typical High $263.03 | Professional | 50 · Both sides | $104.71 | $165.96 | $263.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $100.00 Typical High $151.36 | Professional | 54 · Surgery only | $63.10 | $100.00 | $151.36 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $6.92 | $13.49 | $17.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $83.18 Median $102.33 Typical High $199.53 | Professional | 63 · Small infant | $83.18 | $102.33 | $199.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $100.00 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $50.12 | $100.00 | $120.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $21.88 Typical High $27.54 | Professional | 80 · Assistant surgeon | $11.22 | $21.88 | $27.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $13.49 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $11.22 | $13.49 | $27.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $21.88 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $21.88 | $27.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $9.55 Median $11.48 Typical High $22.91 | Professional | AS · PA/NP assist | $9.55 | $11.48 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $54.95 Typical High $100.00 | Professional | 52 · Reduced service | $29.51 | $54.95 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $21.88 Typical High $39.81 | Professional | 53 · Discontinued | $11.75 | $21.88 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $81.28 Typical High $147.91 | Professional | 54 · Surgery only | $43.65 | $81.28 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $16.22 Typical High $29.51 | Professional | 55 · Aftercare only | $8.91 | $16.22 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.96 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.89 | $10.96 | $19.95 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $165.96 Typical High $302.00 | Professional | 50 · Both sides | $165.96 | $165.96 | $302.00 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $141.25 | Professional | 54 · Surgery only | $77.62 | $77.62 | $141.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $19.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $151.36 |
Where Idaho sits
The same service costs 3.0 times more in Alaska than in Virginia. 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· 17th of 51
$110
AK $182VA $60.26
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.