How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,042 to $15,136Professionalmedian $2,570 · 10th to 90th $1,820 to $3,162
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 $1,819.70 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,819.70 | $2,951.21 | $2,951.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $17,782.79 | Facility | None | $4,073.80 | $5,623.41 | $17,782.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,691.53 | $2,818.38 |
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 $1,698.24 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,995.26 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,951.21 Typical High $5,495.41 | Facility | None | $1,513.56 | $2,951.21 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $3,467.37 | Professional | None | $1,819.70 | $2,951.21 | $3,467.37 |
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 $2,041.74 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,041.74 | $2,511.89 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,511.89 | $2,511.89 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $13,182.57 Typical High $19,054.61 | Facility | None | $6,918.31 | $13,182.57 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,818.38 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,230.27 | Facility | None | $1,174.90 | $1,174.90 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,445.44 | $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 $1,479.11 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,089.30 | $3,019.95 |
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 $912.01 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $912.01 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $363.08 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,380.38 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $275.42 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $181.97 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,089.30 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,344.23 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,089.30 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $281.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,090.30 Typical High $3,388.44 | Professional | 63 · Small infant | $2,754.23 | $3,090.30 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,819.70 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,819.70 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $416.87 Typical High $446.68 | Professional | 80 · Assistant surgeon | $371.54 | $416.87 | $446.68 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $416.87 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $371.54 | $416.87 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $416.87 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $416.87 | $446.68 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $354.81 Typical High $380.19 | Professional | AS · PA/NP assist | $316.23 | $354.81 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $912.01 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $363.08 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,380.38 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $275.42 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $181.97 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,089.30 | $2,089.30 |
Where Idaho sits
The same service costs 19.5 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· 11th of 51
$2,570
AK $5,754TX $295
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.