How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,042 to $14,125Professionalmedian $2,455 · 10th to 90th $1,479 to $3,311
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 $1,348.96 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,348.96 | $3,311.31 | $3,311.31 |
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 $2,290.87 Median $2,691.53 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,691.53 | $2,818.38 |
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 $1,513.56 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,995.26 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,174.90 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,570.40 | $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 $2,041.74 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,041.74 | $2,511.89 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,511.89 | $3,090.30 |
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 $2,187.76 Median $2,691.53 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,691.53 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $10,715.19 | Facility | None | $1,174.90 | $1,202.26 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,174.90 | $1,698.24 |
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 $1,202.26 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,659.59 | $2,691.53 |
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 $758.58 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $758.58 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $302.00 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,122.02 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $223.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $151.36 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,047.13 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,238.72 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,995.26 | $2,238.72 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $281.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $2,951.21 Typical High $3,311.31 | Professional | 63 · Small infant | $2,691.53 | $2,951.21 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,737.80 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,737.80 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 80 · Assistant surgeon | $354.81 | $398.11 | $446.68 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $354.81 | $398.11 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $398.11 | $446.68 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $338.84 Typical High $380.19 | Professional | AS · PA/NP assist | $302.00 | $338.84 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $977.24 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $389.05 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,445.44 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $295.12 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $194.98 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,290.87 | $2,290.87 |
Where Idaho sits
The same service costs 5.9 times more in Alaska 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· 12th of 51
$2,570
AK $5,495UT $933
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.