How much rates vary
Facilitymedian $3,715 · 10th to 90th $891 to $13,183Professionalmedian $891 · 10th to 90th $631 to $1,096
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 $630.96 Median $1,000.00 Typical High $1,000.00 | Professional | None | $630.96 | $1,000.00 | $1,000.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $5,248.07 Typical High $15,135.61 | Facility | None | $2,290.87 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,000.00 | Professional | None | $812.83 | $954.99 | $1,000.00 |
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 $616.60 Median $691.83 Typical High $776.25 | Professional | None | $616.60 | $691.83 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $5,495.41 | Facility | None | $588.84 | $1,000.00 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,174.90 | Professional | None | $630.96 | $1,000.00 | $1,174.90 |
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 $724.44 Median $891.25 Typical High $891.25 | Facility | None | $724.44 | $891.25 | $891.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
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 $933.25 Median $977.24 Typical High $1,174.90 | Professional | None | $933.25 | $977.24 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $426.58 Typical High $10,471.29 | Facility | None | $416.87 | $426.58 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $3,388.44 | Professional | None | $416.87 | $501.19 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,202.26 | Professional | None | $562.34 | $758.58 | $1,202.26 |
21 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 $316.23 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $125.89 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $467.74 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $436.52 | $707.95 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $812.83 | $891.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $91.20 | $100.00 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | 62 · Two surgeons | $512.86 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $977.24 Median $1,096.48 Typical High $1,202.26 | Professional | 63 · Small infant | $977.24 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $691.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 80 · Assistant surgeon | $131.83 | $144.54 | $158.49 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $131.83 | $144.54 | $158.49 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $144.54 | $158.49 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | AS · PA/NP assist | $112.20 | $123.03 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $125.89 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $467.74 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $436.52 | $707.95 | $707.95 |
Where Idaho sits
The same service costs 18.2 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· 12th of 51
$955
AK $1,995TX $110
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.