How much rates vary
Facilitymedian $2,239 · 10th to 90th $891 to $8,710Professionalmedian $2,138 · 10th to 90th $1,479 to $2,951
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 Professional Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,318.26 | $2,137.96 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $9,772.37 | Facility | None | $933.25 | $3,801.89 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,290.87 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $891.25 Typical High $1,202.26 | Facility | None | $776.25 | $891.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,698.24 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,090.30 | Facility | None | $1,318.26 | $2,137.96 | $3,090.30 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,344.23 | $2,818.38 |
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 $1,819.70 Median $1,819.70 Typical High $2,754.23 | Facility | None | $1,819.70 | $1,819.70 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,819.70 | $2,290.87 | $3,467.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $10,471.29 | Facility | None | $5,248.07 | $8,128.31 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,511.89 | $3,311.31 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $10,471.29 | Facility | None | $1,318.26 | $1,348.96 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,778.28 | Professional | None | $812.83 | $1,318.26 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,862.09 | $2,818.38 |
21 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 $660.69 Median $1,071.52 Typical High $1,380.38 | Professional | 52 · Reduced service | $660.69 | $1,071.52 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $426.58 Typical High $562.34 | Professional | 53 · Discontinued | $263.03 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $323.59 Typical High $416.87 | Professional | 55 · Aftercare only | $194.98 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $213.80 Typical High $281.84 | Professional | 56 · Pre-op care only | $131.83 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,513.56 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $912.01 | $1,513.56 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,238.72 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,513.56 | $2,238.72 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $263.03 Typical High $302.00 | Professional | 55 · Aftercare only | $186.21 | $263.03 | $302.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,041.74 Median $2,454.71 Typical High $3,630.78 | Professional | 63 · Small infant | $2,041.74 | $2,454.71 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,737.80 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $398.11 Typical High $501.19 | Professional | 80 · Assistant surgeon | $269.15 | $398.11 | $501.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $371.54 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $269.15 | $371.54 | $478.63 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $323.59 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $323.59 | $478.63 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $275.42 Typical High $407.38 | Professional | AS · PA/NP assist | $229.09 | $275.42 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $1,071.52 Typical High $1,380.38 | Professional | 52 · Reduced service | $660.69 | $1,071.52 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $426.58 Typical High $562.34 | Professional | 53 · Discontinued | $263.03 | $426.58 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $323.59 Typical High $416.87 | Professional | 55 · Aftercare only | $194.98 | $323.59 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $213.80 Typical High $281.84 | Professional | 56 · Pre-op care only | $131.83 | $213.80 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,513.56 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $912.01 | $1,513.56 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $302.00 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,290.87 |
Where Idaho sits
The same service costs 5.0 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· 9th of 51
$2,138
AK $4,169TX $832
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.