How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,148 to $14,125Professionalmedian $1,148 · 10th to 90th $692 to $1,622
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 $645.65 Median $1,000.00 Typical High $1,621.81 | Professional | None | $645.65 | $1,000.00 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,258.93 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,096.48 | Professional | None | $724.44 | $954.99 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,621.81 Typical High $5,495.41 | Facility | None | $588.84 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,621.81 | Professional | None | $933.25 | $1,174.90 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,148.15 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,318.26 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $10,715.19 | Facility | None | $549.54 | $562.34 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $831.76 | Professional | None | $549.54 | $549.54 | $831.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,318.26 | Professional | None | $616.60 | $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 $363.08 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $363.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $147.91 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $549.54 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $109.65 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $72.44 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $512.86 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,479.11 Typical High $1,548.82 | Professional | 63 · Small infant | $1,230.27 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $204.17 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $194.98 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $165.96 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $194.98 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $467.74 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $186.21 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $691.83 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $138.04 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $93.33 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $645.65 | $1,122.02 | $1,122.02 |
Where Idaho sits
The same service costs 8.1 times more in Oklahoma than in Utah. 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· 13th of 51
$1,259
OK $3,548UT $437
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.