How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,042 to $14,125Professionalmedian $2,042 · 10th to 90th $1,479 to $3,467
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $3,467.37 Typical High $3,467.37 | Professional | None | $1,659.59 | $3,467.37 | $3,467.37 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $15,135.61 | Facility | None | $3,235.94 | $4,786.30 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,905.46 | $2,238.72 | $2,398.83 |
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 $1,318.26 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,659.59 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,467.37 Typical High $5,495.41 | Facility | None | $1,174.90 | $3,467.37 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,290.87 | $3,467.37 |
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 $1,659.59 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,659.59 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,290.87 | Professional | None | $2,041.74 | $2,041.74 | $2,290.87 |
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 $2,290.87 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,398.83 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $10,715.19 | Facility | None | $977.24 | $1,000.00 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,513.56 | Professional | None | $977.24 | $977.24 | $1,513.56 |
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 $1,174.90 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,548.82 | $2,290.87 |
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 $891.25 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $891.25 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $363.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,348.96 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $269.15 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $181.97 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,258.93 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,949.84 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $1,949.84 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,630.27 Typical High $2,754.23 | Professional | 63 · Small infant | $2,290.87 | $2,630.27 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,513.56 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 80 · Assistant surgeon | $302.00 | $346.74 | $371.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $302.00 | $346.74 | $371.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $346.74 | $371.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | AS · PA/NP assist | $257.04 | $295.12 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $891.25 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $363.08 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,348.96 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $269.15 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $181.97 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,258.93 | $2,398.83 | $2,398.83 |
Where Idaho sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 16th of 51
$2,239
AK $4,786TX $871
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.