How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,995 to $8,913Professionalmedian $3,020 · 10th to 90th $2,089 to $3,715
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 $1,737.80 Median $3,548.13 Typical High $3,548.13 | Professional | None | $1,737.80 | $3,548.13 | $3,548.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $7,079.46 Typical High $9,772.37 | Facility | None | $5,888.44 | $7,079.46 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,754.23 | $3,235.94 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,677.35 Typical High $6,456.54 | Facility | None | $4,168.69 | $4,677.35 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,398.83 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,513.56 | $3,548.13 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $4,168.69 | Professional | None | $2,187.76 | $3,548.13 | $4,168.69 |
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 $2,398.83 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,398.83 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,801.89 | Professional | None | $2,951.21 | $2,951.21 | $3,801.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $10,232.93 | Facility | None | $6,165.95 | $8,128.31 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,884.03 | $3,388.44 | $4,168.69 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Facility | None | $1,412.54 | $1,412.54 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $4,365.16 | Professional | None | $1,412.54 | $1,737.80 | $4,365.16 |
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 $1,737.80 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,398.83 | $3,630.78 |
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 $1,096.48 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,096.48 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $436.52 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,659.59 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $331.13 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $218.78 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,818.38 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,454.71 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 55 · Aftercare only | $275.42 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,715.35 Typical High $3,981.07 | Professional | 63 · Small infant | $3,311.31 | $3,715.35 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,187.76 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 80 · Assistant surgeon | $436.52 | $501.19 | $537.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $436.52 | $501.19 | $537.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $501.19 | $537.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | AS · PA/NP assist | $371.54 | $416.87 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,096.48 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $436.52 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,659.59 | $2,630.27 | $2,630.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $331.13 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $218.78 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,511.89 | $2,511.89 |
Where Idaho sits
The same service costs 18.2 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· 11th of 51
$3,090
AK $6,918TX $380
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.