How much rates vary
Facilitymedian $417 · 10th to 90th $145 to $2,188Professionalmedian $1,288 · 10th to 90th $933 to $1,549
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 $933.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $933.25 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,348.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $933.25 | $1,047.13 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $5,495.41 | Facility | None | $588.84 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $1,778.28 | Professional | None | $933.25 | $1,513.56 | $1,778.28 |
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 $1,000.00 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,000.00 | $1,230.27 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,230.27 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,479.11 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $630.96 | Facility | None | $588.84 | $588.84 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,122.02 | Professional | None | $588.84 | $741.31 | $1,122.02 |
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 $758.58 Median $1,023.29 Typical High $1,479.11 | Professional | None | $758.58 | $1,023.29 | $1,479.11 |
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 $467.74 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $467.74 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $186.21 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $707.95 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $141.25 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $151.36 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $870.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,584.89 Typical High $1,659.59 | Professional | 63 · Small infant | $1,380.38 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $223.87 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $208.93 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $181.97 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $208.93 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $177.83 Typical High $190.55 | Professional | AS · PA/NP assist | $154.88 | $177.83 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $467.74 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $186.21 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $707.95 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $141.25 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $151.36 |
Where Idaho sits
The same service costs 4.7 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· 11th of 51
$1,259
AK $3,020FL $646
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.