How much rates vary
Facilitymedian $1,259 · 10th to 90th $676 to $4,365Professionalmedian $2,570 · 10th to 90th $1,660 to $3,162
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 $1,862.09 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,951.21 | $2,951.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $4,168.69 | Facility | None | $1,174.90 | $1,905.46 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,754.23 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,995.26 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $5,495.41 | Facility | None | $1,479.11 | $2,951.21 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,951.21 | $3,467.37 |
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 $2,089.30 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,089.30 | $2,570.40 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,235.94 | Professional | None | $2,570.40 | $2,570.40 | $3,235.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,884.03 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $3,801.89 | Facility | None | $1,230.27 | $1,258.93 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,187.76 | Professional | None | $977.24 | $1,230.27 | $2,187.76 |
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 $1,380.38 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,995.26 | $2,884.03 |
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 $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,380.38 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $281.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $186.21 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,398.83 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,137.96 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $263.03 | $288.40 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,818.38 Median $3,162.28 Typical High $3,467.37 | Professional | 63 · Small infant | $2,818.38 | $3,162.28 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,862.09 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $426.58 Typical High $457.09 | Professional | 80 · Assistant surgeon | $380.19 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $426.58 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $380.19 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $426.58 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $363.08 Typical High $389.05 | Professional | AS · PA/NP assist | $323.59 | $363.08 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $933.25 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $371.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,380.38 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $281.84 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $186.21 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,041.74 | $2,041.74 |
Where Idaho sits
The same service costs 17.0 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
$2,570
AK $5,888TX $347
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.