How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,514 to $7,762Professionalmedian $1,698 · 10th to 90th $1,122 to $1,995
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 $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,862.09 | $1,862.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,137.96 | $3,467.37 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,778.28 | $1,905.46 |
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 $1,000.00 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,258.93 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,047.13 | $1,862.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,862.09 | $2,187.76 |
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 $1,380.38 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,380.38 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,698.24 | $2,137.96 |
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 $1,548.82 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,819.70 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $6,309.57 | Facility | None | $812.83 | $812.83 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,862.09 | Professional | None | $812.83 | $891.25 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,819.70 | Professional | None | $933.25 | $1,258.93 | $1,819.70 |
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 $602.56 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $602.56 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $239.88 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $891.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $120.23 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $190.55 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,862.09 Median $2,089.30 Typical High $2,290.87 | Professional | 63 · Small infant | $1,862.09 | $2,089.30 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 80 · Assistant surgeon | $251.19 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $251.19 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | AS · PA/NP assist | $213.80 | $234.42 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $602.56 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $239.88 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $891.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $177.83 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $120.23 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,318.26 | $1,318.26 |
Where Idaho sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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.
Physician feeFacility fee
AK $8,081HI $2,620
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.