How much rates vary
Facilitymedian $575 · 10th to 90th $182 to $3,981Professionalmedian $263 · 10th to 90th $170 to $437
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $407.38 | Professional | None | $158.49 | $234.42 | $407.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $1,819.70 Typical High $3,981.07 | Facility | None | $199.53 | $1,819.70 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $467.74 | Professional | None | $190.55 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $245.47 | Facility | None | $162.18 | $181.97 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $346.74 | Professional | None | $169.82 | $245.47 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $407.38 Typical High $5,495.41 | Facility | None | $158.49 | $407.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $446.68 | Professional | None | $177.83 | $302.00 | $446.68 |
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 $194.98 Median $194.98 Typical High $398.11 | Facility | None | $194.98 | $194.98 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $426.58 | Professional | None | $181.97 | $380.19 | $426.58 |
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 $190.55 Median $251.19 Typical High $380.19 | Professional | None | $190.55 | $251.19 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $208.93 Typical High $2,754.23 | Facility | None | $204.17 | $208.93 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $288.40 | Professional | None | $131.83 | $204.17 | $288.40 |
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 $138.04 Median $269.15 Typical High $426.58 | Professional | None | $138.04 | $269.15 | $426.58 |
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 $79.43 Median $109.65 Typical High $204.17 | Professional | 52 · Reduced service | $79.43 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $81.28 | Professional | 53 · Discontinued | $31.62 | $44.67 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $165.96 Typical High $302.00 | Professional | 54 · Surgery only | $117.49 | $165.96 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $60.26 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $40.74 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $302.00 Median $2,691.53 Typical High $6,025.60 | Facility | 50 · Both sides | $302.00 | $2,691.53 | $6,025.60 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $602.56 Typical High $707.95 | Professional | 50 · Both sides | $288.40 | $602.56 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $436.52 | Professional | 54 · Surgery only | $173.78 | $213.80 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.44 Typical High $48.98 | Professional | 55 · Aftercare only | $19.50 | $23.44 | $48.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $234.42 Median $281.84 Typical High $588.84 | Professional | 63 · Small infant | $234.42 | $281.84 | $588.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $134.90 | $275.42 | $338.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $66.07 Typical High $77.62 | Professional | 80 · Assistant surgeon | $30.90 | $66.07 | $77.62 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $38.02 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $32.36 | $38.02 | $77.62 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $38.02 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $38.02 | $75.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $30.90 Typical High $66.07 | Professional | AS · PA/NP assist | $25.70 | $30.90 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $109.65 Typical High $204.17 | Professional | 52 · Reduced service | $79.43 | $109.65 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $81.28 | Professional | 53 · Discontinued | $31.62 | $44.67 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $165.96 Typical High $302.00 | Professional | 54 · Surgery only | $117.49 | $165.96 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $60.26 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $40.74 |
Where Idaho sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 18th of 51
$295
OK $692TX $214
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.