How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,479 to $14,125Professionalmedian $1,549 · 10th to 90th $1,072 to $1,862
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 $1,096.48 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,778.28 | $1,778.28 |
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 $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,621.81 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,495.41 | $6,165.95 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,202.26 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $5,495.41 | Facility | None | $1,096.48 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,778.28 | $2,089.30 |
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 $1,230.27 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,230.27 | $1,479.11 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,479.11 | $1,905.46 |
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 $1,513.56 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,698.24 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $10,471.29 | Facility | None | $707.95 | $724.44 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $5,623.41 | Professional | None | $707.95 | $851.14 | $5,623.41 |
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 $891.25 Median $1,258.93 Typical High $1,819.70 | Professional | None | $891.25 | $1,258.93 | $1,819.70 |
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 $549.54 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $549.54 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $218.78 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $812.83 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $109.65 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $758.58 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $165.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,862.09 Typical High $1,995.26 | Professional | 63 · Small infant | $1,659.59 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 80 · Assistant surgeon | $218.78 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $218.78 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $245.47 | $269.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | AS · PA/NP assist | $186.21 | $208.93 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $549.54 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $218.78 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $812.83 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $109.65 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $758.58 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 17.8 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
$1,585
AK $3,388TX $191
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.