How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,692 to $17,378Professionalmedian $4,898 · 10th to 90th $3,236 to $6,026
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $5,754.40 | Professional | None | $3,548.13 | $5,754.40 | $5,754.40 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $6,309.57 Typical High $18,620.87 | Facility | None | $3,467.37 | $6,309.57 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $5,623.41 | Professional | None | $4,466.84 | $5,248.07 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $4,466.84 | Professional | None | $3,162.28 | $3,890.45 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $2,290.87 Median $4,466.84 Typical High $8,128.31 | Facility | None | $2,290.87 | $4,466.84 | $8,128.31 |
Moda Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $6,760.83 | Professional | None | $3,548.13 | $5,754.40 | $6,760.83 |
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 $3,981.07 Median $4,786.30 Typical High $4,786.30 | Facility | None | $3,981.07 | $4,786.30 | $4,786.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,165.95 | Professional | None | $4,786.30 | $4,786.30 | $6,165.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $6,760.83 | Professional | None | $4,786.30 | $5,623.41 | $6,760.83 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $13,182.57 | Facility | None | $2,290.87 | $2,344.23 | $13,182.57 |
Select Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,818.38 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,801.89 Typical High $5,370.32 | Professional | None | $2,511.89 | $3,801.89 | $5,370.32 |
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 $1,778.28 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,778.28 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $707.95 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,691.53 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $537.03 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $354.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,981.07 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,981.07 Median $4,570.88 Typical High $4,897.79 | Professional | 54 · Surgery only | $3,981.07 | $4,570.88 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | 55 · Aftercare only | $446.68 | $501.19 | $537.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,370.32 Median $6,025.60 Typical High $6,456.54 | Professional | 63 · Small infant | $5,370.32 | $6,025.60 | $6,456.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,548.13 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,548.13 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $707.95 Median $812.83 Typical High $870.96 | Professional | 80 · Assistant surgeon | $707.95 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $707.95 Median $812.83 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $707.95 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $707.95 Median $812.83 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $707.95 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $691.83 Typical High $741.31 | Professional | AS · PA/NP assist | $602.56 | $691.83 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,778.28 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,778.28 | $2,884.03 | $2,884.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $707.95 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,691.53 | $4,265.80 | $4,265.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $537.03 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $354.81 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,981.07 | $3,981.07 |
Where Idaho sits
The same service costs 19.5 times more in Alaska 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· 10th of 51
$4,898
AK $11,482TX $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.