How much rates vary
Facilitymedian $251 · 10th to 90th $117 to $851Professionalmedian $234 · 10th to 90th $132 to $316
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 $120.23 Median $251.19 Typical High $316.23 | Professional | None | $120.23 | $251.19 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $758.58 | Facility | None | $125.89 | $354.81 | $758.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $316.23 | Professional | None | $194.98 | $263.03 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $162.18 | Facility | None | $104.71 | $117.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $234.42 | Professional | None | $114.82 | $186.21 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $316.23 Typical High $5,495.41 | Facility | None | $134.90 | $316.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $316.23 | Professional | None | $134.90 | $245.47 | $316.23 |
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 $204.17 Median $204.17 Typical High $281.84 | Facility | None | $204.17 | $204.17 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $363.08 | Professional | None | $177.83 | $245.47 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $954.99 | Facility | None | $501.19 | $758.58 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $288.40 | Professional | None | $194.98 | $245.47 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $724.44 | Facility | None | $134.90 | $138.04 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $213.80 | Professional | None | $87.10 | $134.90 | $213.80 |
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 $125.89 Median $177.83 Typical High $269.15 | Professional | None | $125.89 | $177.83 | $269.15 |
26 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 $117.49 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | 54 · Surgery only | $173.78 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $223.87 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $190.55 Median $512.86 Typical High $1,148.15 | Facility | 50 · Both sides | $190.55 | $512.86 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $380.19 Typical High $446.68 | Professional | 50 · Both sides | $281.84 | $380.19 | $446.68 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $169.82 | $263.03 | $288.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $19.05 | $26.92 | $31.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $229.09 Median $323.59 Typical High $371.54 | Professional | 63 · Small infant | $229.09 | $323.59 | $371.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $177.83 | $208.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $37.15 Typical High $57.54 | Professional | 80 · Assistant surgeon | $30.20 | $37.15 | $57.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $42.66 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $30.20 | $42.66 | $51.29 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $42.66 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $42.66 | $48.98 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $31.62 Typical High $48.98 | Professional | AS · PA/NP assist | $25.70 | $31.62 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $125.89 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $50.12 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | 54 · Surgery only | $173.78 | $190.55 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $436.52 Typical High $549.54 | Professional | 50 · Both sides | $436.52 | $436.52 | $549.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $204.17 | $204.17 | $251.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $269.15 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in Florida. 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
$234
AK $468FL $115
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.