How much rates vary
Facilitymedian $5,370 · 10th to 90th $2,344 to $10,233Professionalmedian $2,455 · 10th to 90th $1,738 to $3,020
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 $1,778.28 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,011.87 Median $6,918.31 Typical High $12,022.64 | Facility | None | $5,011.87 | $6,918.31 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,630.27 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,949.84 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,818.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,818.38 | $3,311.31 |
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 $1,995.26 Median $2,398.83 Typical High $2,398.83 | Facility | None | $1,995.26 | $2,398.83 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,090.30 | Professional | None | $2,398.83 | $2,398.83 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,398.83 | $2,818.38 | $3,311.31 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Facility | None | $1,148.15 | $1,148.15 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $5,248.07 | Professional | None | $1,148.15 | $1,380.38 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,479.11 | $2,041.74 | $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 $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $891.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $354.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,318.26 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $263.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,238.72 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,995.26 | $2,238.72 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,019.95 Typical High $3,235.94 | Professional | 63 · Small infant | $2,691.53 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,737.80 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,737.80 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 80 · Assistant surgeon | $354.81 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $354.81 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | AS · PA/NP assist | $302.00 | $338.84 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $891.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $354.81 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,318.26 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $263.03 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $177.83 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 18.6 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· 11th of 51
$2,512
AK $5,623TX $302
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.