How much rates vary
Facilitymedian $417 · 10th to 90th $145 to $1,995Professionalmedian $1,175 · 10th to 90th $871 to $1,445
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 $870.96 Median $1,412.54 Typical High $1,412.54 | Professional | None | $870.96 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,230.27 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,096.48 | Professional | None | $851.14 | $954.99 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $5,495.41 | Facility | None | $537.03 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $1,621.81 | Professional | None | $870.96 | $1,412.54 | $1,621.81 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,148.15 | $1,479.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,380.38 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $575.44 | Facility | None | $537.03 | $537.03 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,047.13 | Professional | None | $537.03 | $676.08 | $1,047.13 |
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 $691.83 Median $933.25 Typical High $1,348.96 | Professional | None | $691.83 | $933.25 | $1,348.96 |
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 $436.52 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $173.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $645.65 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $128.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $87.10 | $141.25 | $141.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $128.82 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $758.58 Typical High $794.33 | Professional | 62 · Two surgeons | $660.69 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 63 · Small infant | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 80 · Assistant surgeon | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $173.78 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $645.65 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $128.82 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $87.10 | $141.25 | $141.25 |
Where Idaho sits
The same service costs 4.7 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
$1,175
AK $2,754UT $589
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.