How much rates vary
Facilitymedian $3,548 · 10th to 90th $676 to $11,749Professionalmedian $1,000 · 10th to 90th $646 to $1,585
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,548.82 | Professional | None | $645.65 | $954.99 | $1,548.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,230.27 Median $5,248.07 Typical High $15,135.61 | Facility | None | $1,230.27 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,621.81 | Professional | None | $812.83 | $1,122.02 | $1,621.81 |
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 $575.44 Median $776.25 Typical High $1,202.26 | Professional | None | $575.44 | $776.25 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $1,380.38 Typical High $5,495.41 | Facility | None | $416.87 | $1,380.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,548.82 | Professional | None | $758.58 | $1,122.02 | $1,548.82 |
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 $891.25 Median $891.25 Typical High $1,479.11 | Facility | None | $891.25 | $891.25 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $891.25 | $1,122.02 | $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 $912.01 Median $1,122.02 Typical High $1,778.28 | Professional | None | $912.01 | $1,122.02 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $4,677.35 | Facility | None | $707.95 | $724.44 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $3,388.44 | Professional | None | $446.68 | $707.95 | $3,388.44 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,258.93 | Professional | None | $457.09 | $758.58 | $1,258.93 |
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 $323.59 Median $478.63 Typical High $776.25 | Professional | 52 · Reduced service | $323.59 | $478.63 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $190.55 Typical High $309.03 | Professional | 53 · Discontinued | $128.82 | $190.55 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $478.63 | $724.44 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $144.54 Typical High $234.42 | Professional | 55 · Aftercare only | $95.50 | $144.54 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $95.50 Typical High $154.88 | Professional | 56 · Pre-op care only | $64.57 | $95.50 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,202.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $741.31 | $1,202.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $131.83 Typical High $162.18 | Professional | 55 · Aftercare only | $81.28 | $131.83 | $162.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $977.24 Median $1,202.26 Typical High $1,905.46 | Professional | 63 · Small infant | $977.24 | $1,202.26 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $257.04 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $158.49 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $131.83 | $158.49 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $158.49 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $158.49 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $208.93 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $478.63 Typical High $776.25 | Professional | 52 · Reduced service | $323.59 | $478.63 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $190.55 Typical High $309.03 | Professional | 53 · Discontinued | $128.82 | $190.55 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $478.63 | $724.44 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $144.54 Typical High $234.42 | Professional | 55 · Aftercare only | $95.50 | $144.54 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $95.50 Typical High $154.88 | Professional | 56 · Pre-op care only | $64.57 | $95.50 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $707.95 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $162.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,202.26 |
Where Idaho sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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
$1,000
AK $2,138KY $363
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.