How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,202 to $13,183Professionalmedian $1,318 · 10th to 90th $912 to $1,622
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 $776.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $776.25 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $15,135.61 | Facility | None | $2,951.21 | $4,073.80 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,412.54 | $1,479.11 |
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 $831.76 Median $1,023.29 Typical High $1,148.15 | Professional | None | $831.76 | $1,023.29 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $5,495.41 | Facility | None | $812.83 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,778.28 | Professional | None | $954.99 | $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 $1,047.13 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,047.13 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
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 $1,479.11 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,479.11 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $10,471.29 | Facility | None | $616.60 | $630.96 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $3,388.44 | Professional | None | $616.60 | $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 $758.58 Median $1,071.52 Typical High $1,513.56 | Professional | None | $758.58 | $1,071.52 | $1,513.56 |
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 $478.63 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $144.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 63 · Small infant | $1,445.44 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 80 · Assistant surgeon | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | AS · PA/NP assist | $162.18 | $181.97 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
Where Idaho sits
The same service costs 8.5 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
$1,349
AK $3,020TX $355
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.