How much rates vary
Facilitymedian $3,631 · 10th to 90th $759 to $14,125Professionalmedian $741 · 10th to 90th $372 to $1,096
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $1,096.48 Typical High $1,096.48 | Professional | None | $288.40 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $7,413.10 Typical High $17,782.79 | Facility | None | $2,290.87 | $7,413.10 | $17,782.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $891.25 | Professional | None | $676.08 | $812.83 | $891.25 |
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 $537.03 Median $645.65 Typical High $758.58 | Professional | None | $537.03 | $645.65 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $1,096.48 Typical High $4,466.84 | Facility | None | $316.23 | $1,096.48 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,096.48 | Professional | None | $602.56 | $758.58 | $1,096.48 |
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 $602.56 Median $741.31 Typical High $741.31 | Facility | None | $602.56 | $741.31 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | None | $741.31 | $741.31 | $851.14 |
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 $758.58 Median $891.25 Typical High $912.01 | Professional | None | $758.58 | $891.25 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $5,128.61 | Facility | None | $354.81 | $363.08 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $575.44 | Professional | None | $354.81 | $354.81 | $575.44 |
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 $281.84 Median $489.78 Typical High $831.76 | Professional | None | $281.84 | $489.78 | $831.76 |
19 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 $245.47 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $245.47 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $100.00 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $371.54 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $74.13 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $48.98 | $109.65 | $109.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $707.95 | $758.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $83.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $524.81 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $524.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $794.33 Median $954.99 Typical High $1,000.00 | Professional | 63 · Small infant | $794.33 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $588.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $134.90 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $134.90 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $125.89 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $107.15 | $125.89 | $134.90 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $125.89 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $125.89 | $134.90 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $114.82 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $302.00 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $120.23 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $446.68 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $89.13 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $60.26 | $109.65 | $109.65 |
Where Idaho sits
The same service costs 5.2 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· 11th of 51
$832
AK $1,820KY $347
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.