How much rates vary
Facilitymedian $2,089 · 10th to 90th $339 to $8,511Professionalmedian $288 · 10th to 90th $178 to $457
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 $173.78 Median $309.03 Typical High $524.81 | Professional | None | $173.78 | $309.03 | $524.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $3,019.95 Typical High $9,772.37 | Facility | None | $1,819.70 | $3,019.95 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $457.09 | Professional | None | $204.17 | $323.59 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,862.09 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $338.84 | Professional | None | $177.83 | $234.42 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $446.68 Typical High $5,495.41 | Facility | None | $158.49 | $446.68 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $524.81 | Professional | None | $186.21 | $309.03 | $524.81 |
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 $218.78 Median $218.78 Typical High $416.87 | Facility | None | $218.78 | $218.78 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $426.58 | Professional | None | $218.78 | $257.04 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $12,302.69 | Facility | None | $6,025.60 | $8,511.38 | $12,302.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $436.52 | Professional | None | $251.19 | $275.42 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $6,025.60 | Facility | None | $199.53 | $204.17 | $6,025.60 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $275.42 | Professional | None | $138.04 | $199.53 | $275.42 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $398.11 | Professional | None | $138.04 | $229.09 | $398.11 |
18 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 $87.10 Median $154.88 Typical High $263.03 | Professional | 52 · Reduced service | $87.10 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $63.10 Typical High $104.71 | Professional | 53 · Discontinued | $34.67 | $63.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $398.11 | Professional | 54 · Surgery only | $128.82 | $234.42 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $46.77 Typical High $79.43 | Professional | 55 · Aftercare only | $25.70 | $46.77 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $30.90 Typical High $52.48 | Professional | 56 · Pre-op care only | $17.38 | $30.90 | $52.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $389.05 | Professional | 54 · Surgery only | $181.97 | $218.78 | $389.05 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $43.65 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $295.12 Typical High $562.34 | Professional | 63 · Small infant | $245.47 | $295.12 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $316.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $38.90 Typical High $64.57 | Professional | 80 · Assistant surgeon | $36.31 | $38.90 | $64.57 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $38.90 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $32.36 | $38.90 | $72.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $39.81 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $39.81 | $72.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $32.36 Typical High $64.57 | Professional | AS · PA/NP assist | $27.54 | $32.36 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $154.88 Typical High $263.03 | Professional | 52 · Reduced service | $87.10 | $154.88 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $63.10 Typical High $104.71 | Professional | 53 · Discontinued | $34.67 | $63.10 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $398.11 | Professional | 54 · Surgery only | $128.82 | $234.42 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $46.77 Typical High $79.43 | Professional | 55 · Aftercare only | $25.70 | $46.77 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $30.90 Typical High $52.48 | Professional | 56 · Pre-op care only | $17.38 | $30.90 | $52.48 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$331
AK $708KY $191
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.