How much rates vary
Facilitymedian $2,042 · 10th to 90th $676 to $7,244Professionalmedian $1,514 · 10th to 90th $1,000 to $1,820
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 $1,071.52 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,698.24 | $1,698.24 |
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 $1,412.54 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,621.81 | $1,698.24 |
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 $891.25 Median $1,122.02 Typical High $1,258.93 | Professional | None | $891.25 | $1,122.02 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $5,495.41 | Facility | None | $812.83 | $1,698.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,698.24 | $1,949.84 |
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,230.27 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,513.56 | $1,905.46 |
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 $1,412.54 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,659.59 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $741.31 Typical High $3,630.78 | Facility | None | $724.44 | $741.31 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,862.09 | Professional | None | $724.44 | $812.83 | $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 $794.33 Median $1,122.02 Typical High $1,621.81 | Professional | None | $794.33 | $1,122.02 | $1,621.81 |
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 $537.03 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $107.15 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $169.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $1,862.09 Typical High $2,041.74 | Professional | 63 · Small infant | $1,698.24 | $1,862.09 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 80 · Assistant surgeon | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | AS · PA/NP assist | $190.55 | $213.80 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $107.15 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,174.90 |
Where Idaho sits
The same service costs 8.3 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
$1,514
AK $3,388TX $407
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.