How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,096 to $13,183Professionalmedian $1,259 · 10th to 90th $891 to $1,660
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 $870.96 Median $1,348.96 Typical High $1,659.59 | Professional | None | $870.96 | $1,348.96 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $15,135.61 | Facility | None | $2,187.76 | $4,073.80 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,318.26 | $1,584.89 |
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 $812.83 Median $1,023.29 Typical High $1,258.93 | Professional | None | $812.83 | $1,023.29 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $5,495.41 | Facility | None | $630.96 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,659.59 | Professional | None | $933.25 | $1,348.96 | $1,659.59 |
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 $1,096.48 Median $1,096.48 Typical High $1,479.11 | Facility | None | $1,096.48 | $1,096.48 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,380.38 | $1,862.09 |
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 $1,258.93 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,548.82 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $4,570.88 | Facility | None | $691.83 | $707.95 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $3,388.44 | Professional | None | $630.96 | $691.83 | $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 $676.08 Median $977.24 Typical High $1,479.11 | Professional | None | $676.08 | $977.24 | $1,479.11 |
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 $426.58 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $426.58 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $173.78 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,000.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $645.65 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $204.17 Typical High $251.19 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $87.10 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $602.56 | $933.25 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,479.11 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $102.33 | $134.90 | $158.49 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,479.11 Typical High $1,905.46 | Professional | 63 · Small infant | $1,230.27 | $1,479.11 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $223.87 Typical High $257.04 | Professional | 80 · Assistant surgeon | $162.18 | $223.87 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $218.78 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $162.18 | $218.78 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $223.87 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $223.87 | $263.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $169.82 Typical High $218.78 | Professional | AS · PA/NP assist | $138.04 | $169.82 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $426.58 | $676.08 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $173.78 | $269.15 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,000.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $645.65 | $1,000.00 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $204.17 Typical High $251.19 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $87.10 | $134.90 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $602.56 | $933.25 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,288.25 |
Where Idaho sits
The same service costs 6.6 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
$1,259
AK $3,020TX $457
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.