How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,072 to $13,183Professionalmedian $1,259 · 10th to 90th $851 to $1,698
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $1,698.24 | Professional | None | $794.33 | $1,288.25 | $1,698.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,248.07 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,348.96 | $1,698.24 |
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 $794.33 Median $954.99 Typical High $1,258.93 | Professional | None | $794.33 | $954.99 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $5,495.41 | Facility | None | $691.83 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,698.24 | Professional | None | $912.01 | $1,318.26 | $1,698.24 |
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 $1,071.52 Median $1,071.52 Typical High $1,548.82 | Facility | None | $1,071.52 | $1,071.52 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,348.96 | $1,949.84 |
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 $1,202.26 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,513.56 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $10,471.29 | Facility | None | $741.31 | $758.58 | $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 $1,698.24 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 $660.69 Median $1,000.00 Typical High $1,548.82 | Professional | None | $660.69 | $1,000.00 | $1,548.82 |
23 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 $398.11 Median $630.96 Typical High $851.14 | Professional | 52 · Reduced service | $398.11 | $630.96 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $257.04 Typical High $338.84 | Professional | 53 · Discontinued | $158.49 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $588.84 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $190.55 Typical High $251.19 | Professional | 55 · Aftercare only | $117.49 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $128.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $79.43 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $549.54 | $891.25 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $891.25 | $1,288.25 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $120.23 Typical High $169.82 | Professional | 55 · Aftercare only | $100.00 | $120.23 | $169.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,445.44 Typical High $2,041.74 | Professional | 63 · Small infant | $1,202.26 | $1,445.44 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $851.14 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $691.83 | $851.14 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $229.09 Typical High $281.84 | Professional | 80 · Assistant surgeon | $158.49 | $229.09 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $186.21 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $158.49 | $186.21 | $269.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $194.98 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $194.98 | $281.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $630.96 Typical High $851.14 | Professional | 52 · Reduced service | $398.11 | $630.96 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $257.04 Typical High $338.84 | Professional | 53 · Discontinued | $158.49 | $257.04 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $588.84 | $954.99 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $190.55 Typical High $251.19 | Professional | 55 · Aftercare only | $117.49 | $190.55 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $128.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $79.43 | $128.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $549.54 | $891.25 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,318.26 |
Where Idaho sits
The same service costs 6.2 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· 9th of 51
$1,288
AK $3,020TX $490
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.