How much rates vary
Facilitymedian $912 · 10th to 90th $437 to $3,981Professionalmedian $398 · 10th to 90th $282 to $589
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $794.33 | Professional | None | $245.47 | $398.11 | $794.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $3,981.07 | Facility | None | $630.96 | $1,230.27 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $588.84 | Professional | None | $338.84 | $426.58 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $436.52 | Professional | None | $281.84 | $346.74 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $794.33 Typical High $5,495.41 | Facility | None | $251.19 | $794.33 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $794.33 | Professional | None | $288.40 | $457.09 | $794.33 |
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 $371.54 Median $371.54 Typical High $537.03 | Facility | None | $371.54 | $371.54 | $537.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $537.03 | Professional | None | $371.54 | $446.68 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $537.03 | Professional | None | $380.19 | $426.58 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $2,691.53 | Facility | None | $257.04 | $263.03 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $346.74 | Professional | None | $234.42 | $257.04 | $346.74 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $575.44 | Professional | None | $229.09 | $363.08 | $575.44 |
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 $144.54 Median $288.40 Typical High $398.11 | Professional | 52 · Reduced service | $144.54 | $288.40 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $117.49 Typical High $158.49 | Professional | 53 · Discontinued | $57.54 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $436.52 Typical High $588.84 | Professional | 54 · Surgery only | $213.80 | $436.52 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $42.66 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $57.54 Typical High $79.43 | Professional | 56 · Pre-op care only | $28.84 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $407.38 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $199.53 | $407.38 | $549.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $371.54 | $478.63 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $33.88 | $50.12 | $58.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $407.38 Median $616.60 Typical High $707.95 | Professional | 63 · Small infant | $407.38 | $616.60 | $707.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $346.74 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $275.42 | $346.74 | $426.58 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $66.07 Typical High $93.33 | Professional | 80 · Assistant surgeon | $54.95 | $66.07 | $93.33 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $79.43 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $54.95 | $79.43 | $97.72 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $64.57 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $64.57 | $97.72 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $54.95 Typical High $83.18 | Professional | AS · PA/NP assist | $47.86 | $54.95 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $288.40 Typical High $398.11 | Professional | 52 · Reduced service | $144.54 | $288.40 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $117.49 Typical High $158.49 | Professional | 53 · Discontinued | $57.54 | $117.49 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $436.52 Typical High $588.84 | Professional | 54 · Surgery only | $213.80 | $436.52 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $42.66 | $87.10 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $57.54 Typical High $79.43 | Professional | 56 · Pre-op care only | $28.84 | $57.54 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $407.38 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $199.53 | $407.38 | $549.54 |
Where Idaho sits
The same service costs 4.3 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· 11th of 51
$457
AK $1,000UT $234
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.