How much rates vary
Facilitymedian $977 · 10th to 90th $646 to $3,981Professionalmedian $1,175 · 10th to 90th $813 to $1,479
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 $812.83 Median $1,230.27 Typical High $1,479.11 | Professional | None | $812.83 | $1,230.27 | $1,479.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,778.28 Typical High $3,981.07 | Facility | None | $912.01 | $1,778.28 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,230.27 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,122.02 | Professional | None | $741.31 | $933.25 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $5,495.41 | Facility | None | $457.09 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,479.11 | Professional | None | $933.25 | $1,230.27 | $1,479.11 |
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 $1,380.38 | Facility | None | $1,096.48 | $1,096.48 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,380.38 | $1,737.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,412.54 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $1,995.26 | Facility | None | $660.69 | $676.08 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $891.25 | Professional | None | $588.84 | $660.69 | $891.25 |
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 $616.60 Median $912.01 Typical High $1,380.38 | Professional | None | $616.60 | $912.01 | $1,380.38 |
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 $407.38 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $407.38 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $245.47 Typical High $295.12 | Professional | 53 · Discontinued | $162.18 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $602.56 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $81.28 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $562.34 | $851.14 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $154.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,548.82 Typical High $1,862.09 | Professional | 63 · Small infant | $1,202.26 | $1,548.82 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $707.95 | $933.25 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $239.88 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $239.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $162.18 | $190.55 | $229.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $190.55 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $190.55 | $239.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $407.38 | $616.60 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $245.47 Typical High $295.12 | Professional | 53 · Discontinued | $162.18 | $245.47 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $602.56 | $912.01 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $81.28 | $123.03 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $562.34 | $851.14 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $154.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,174.90 |
Where Idaho sits
The same service costs 5.6 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
$1,175
AK $2,399TX $427
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.