How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,380 to $14,125Professionalmedian $1,380 · 10th to 90th $891 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 $812.83 Median $1,995.26 Typical High $1,995.26 | Professional | None | $812.83 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,754.40 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,513.56 | $1,621.81 |
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 $933.25 Median $1,174.90 Typical High $1,348.96 | Professional | None | $933.25 | $1,174.90 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $5,495.41 | Facility | None | $758.58 | $1,995.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,548.82 | $1,995.26 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,122.02 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,380.38 | $1,698.24 |
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 $1,318.26 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,621.81 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $10,715.19 | Facility | None | $660.69 | $676.08 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,000.00 | Professional | None | $660.69 | $660.69 | $1,000.00 |
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 $758.58 Median $1,122.02 Typical High $1,659.59 | Professional | None | $758.58 | $1,122.02 | $1,659.59 |
17 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 $446.68 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $446.68 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $177.83 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $676.08 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $134.90 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $89.13 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $630.96 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $977.24 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | 63 · Small infant | $1,513.56 | $1,778.28 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $1,047.13 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $562.34 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $229.09 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $851.14 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $169.82 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $112.20 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $794.33 | $1,380.38 | $1,380.38 |
Where Idaho sits
The same service costs 4.2 times more in Alaska than in Montana. 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 $10,315MT $2,461
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.