How much rates vary
Facilitymedian $525 · 10th to 90th $347 to $4,169Professionalmedian $525 · 10th to 90th $355 to $794
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 $630.96 Median $912.01 Typical High $5,495.41 | Facility | None | $630.96 | $912.01 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $758.58 | Professional | None | $323.59 | $524.81 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $354.81 Median $741.31 Typical High $4,265.80 | Facility | None | $354.81 | $741.31 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $831.76 | Professional | None | $446.68 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $346.74 Typical High $467.74 | Facility | None | $309.03 | $346.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $575.44 | Professional | None | $338.84 | $407.38 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $758.58 Typical High $4,466.84 | Facility | None | $363.08 | $758.58 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $616.60 Typical High $891.25 | Professional | None | $380.19 | $616.60 | $891.25 |
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 $478.63 Median $478.63 Typical High $758.58 | Facility | None | $478.63 | $478.63 | $758.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $954.99 | Professional | None | $478.63 | $602.56 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $891.25 | Professional | None | $524.81 | $616.60 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Facility | None | $363.08 | $363.08 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $467.74 | Professional | None | $263.03 | $363.08 | $467.74 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $691.83 | Professional | None | $281.84 | $426.58 | $691.83 |
23 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 $165.96 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $165.96 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $67.61 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $251.19 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $537.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 54 · Surgery only | $398.11 | $489.78 | $707.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $81.28 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $81.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $549.54 Median $851.14 Typical High $1,000.00 | Professional | 63 · Small infant | $549.54 | $851.14 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $489.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $331.13 | $489.78 | $575.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $107.15 Typical High $131.83 | Professional | 80 · Assistant surgeon | $70.79 | $107.15 | $131.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $87.10 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $70.79 | $87.10 | $125.89 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $107.15 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $107.15 | $138.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $70.79 Typical High $112.20 | Professional | AS · PA/NP assist | $60.26 | $70.79 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $165.96 | $263.03 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $67.61 | $104.71 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $251.19 | $398.11 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $575.44 | Professional | 54 · Surgery only | $407.38 | $407.38 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $616.60 |
Where Idaho sits
The same service costs 4.5 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
$525
AK $1,072TX $240
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.