How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,202 to $13,183Professionalmedian $1,349 · 10th to 90th $955 to $1,660
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 $4,466.84 Median $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $1,513.56 | Professional | None | $870.96 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $5,128.61 Typical High $15,135.61 | Facility | None | $1,819.70 | $5,128.61 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,479.11 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,202.26 | Professional | None | $851.14 | $1,047.13 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $5,495.41 | Facility | None | $707.95 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,000.00 | $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 $1,096.48 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,096.48 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,513.56 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $4,677.35 | Facility | None | $645.65 | $660.69 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $3,388.44 | Professional | None | $645.65 | $741.31 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,548.82 | Professional | None | $724.44 | $1,047.13 | $1,548.82 |
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 $501.19 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $501.19 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $199.53 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $758.58 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $151.36 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $707.95 | $1,071.52 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $151.36 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,479.11 Median $1,659.59 Typical High $1,819.70 | Professional | 63 · Small infant | $1,479.11 | $1,659.59 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 80 · Assistant surgeon | $199.53 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $199.53 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $190.55 Typical High $204.17 | Professional | AS · PA/NP assist | $169.82 | $190.55 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $501.19 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $199.53 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $758.58 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $151.36 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $707.95 | $1,071.52 | $1,071.52 |
Where Idaho sits
The same service costs 17.4 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
$1,413
AK $3,020TX $174
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.