How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,950 to $8,710Professionalmedian $2,455 · 10th to 90th $1,738 to $3,090
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 $1,778.28 Median $2,884.03 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $9,772.37 | Facility | None | $4,677.35 | $5,888.44 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,630.27 | $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 $1,621.81 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,949.84 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,884.03 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,884.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,884.03 | $3,388.44 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,454.71 | $2,454.71 | $3,090.30 |
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 $2,398.83 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,818.38 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Facility | None | $1,148.15 | $1,148.15 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $4,365.16 | Professional | None | $1,148.15 | $1,412.54 | $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 $1,949.84 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,949.84 | $2,951.21 |
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 $891.25 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $891.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $354.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,348.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $269.15 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $177.83 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,290.87 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,290.87 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,019.95 Typical High $3,235.94 | Professional | 63 · Small infant | $2,691.53 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 80 · Assistant surgeon | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $407.38 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | AS · PA/NP assist | $302.00 | $346.74 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $891.25 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $354.81 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,348.96 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $269.15 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $177.83 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 20.0 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
$2,512
AK $5,754TX $288
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.