How much rates vary
Facilitymedian $2,042 · 10th to 90th $631 to $7,244Professionalmedian $1,288 · 10th to 90th $832 to $1,514
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,412.54 | Professional | None | $912.01 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $8,511.38 | Facility | None | $1,258.93 | $2,187.76 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,380.38 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,047.13 | Professional | None | $741.31 | $933.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $5,495.41 | Facility | None | $776.25 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,621.81 | Professional | None | $912.01 | $1,412.54 | $1,621.81 |
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 $1,047.13 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,047.13 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
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 $1,202.26 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,380.38 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $4,168.69 | Facility | None | $616.60 | $630.96 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,862.09 | Professional | None | $616.60 | $676.08 | $1,862.09 |
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 $660.69 Median $891.25 Typical High $1,318.26 | Professional | None | $660.69 | $891.25 | $1,318.26 |
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 $457.09 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $457.09 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $181.97 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $676.08 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $134.90 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $91.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $630.96 | $977.24 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $144.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 63 · Small infant | $1,445.44 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 80 · Assistant surgeon | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | AS · PA/NP assist | $162.18 | $181.97 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $457.09 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $181.97 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $676.08 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $134.90 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $91.20 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $630.96 | $977.24 | $977.24 |
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· 9th of 51
$1,288
AK $2,754TX $355
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.