How much rates vary
Facilitymedian $2,570 · 10th to 90th $676 to $7,762Professionalmedian $1,905 · 10th to 90th $1,318 to $2,344
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $8,511.38 | Facility | None | $1,258.93 | $2,290.87 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,041.74 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,981.07 | Facility | None | $2,570.40 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,479.11 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $7,762.47 | Facility | None | $891.25 | $2,137.96 | $7,762.47 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,137.96 | $2,511.89 |
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 $1,548.82 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,548.82 | $1,905.46 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,905.46 | $1,905.46 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,137.96 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $4,168.69 | Facility | None | $891.25 | $912.01 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,691.53 | Professional | None | $891.25 | $1,071.52 | $2,691.53 |
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 $1,096.48 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,548.82 | $2,290.87 |
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 $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $676.08 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $269.15 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $134.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $213.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,089.30 Median $2,344.23 Typical High $2,511.89 | Professional | 63 · Small infant | $2,089.30 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | 80 · Assistant surgeon | $281.84 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $281.84 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | AS · PA/NP assist | $234.42 | $263.03 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $676.08 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $269.15 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $134.90 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 7.8 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
$1,905
AK $4,365TX $562
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.