How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,047 to $12,589Professionalmedian $1,349 · 10th to 90th $891 to $1,950
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,691.53 | Professional | None | $933.25 | $1,949.84 | $2,691.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $15,135.61 | Facility | None | $2,187.76 | $4,073.80 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,862.09 | Professional | None | $977.24 | $1,380.38 | $1,862.09 |
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 $891.25 Median $1,071.52 Typical High $1,445.44 | Professional | None | $891.25 | $1,071.52 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,949.84 Typical High $5,495.41 | Facility | None | $645.65 | $1,949.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,691.53 | Professional | None | $933.25 | $1,479.11 | $2,691.53 |
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 $1,047.13 Median $1,047.13 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,047.13 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,318.26 | $1,737.80 |
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 $1,288.25 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,380.38 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $10,715.19 | Facility | None | $776.25 | $794.33 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,047.13 | Professional | None | $676.08 | $776.25 | $1,047.13 |
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 $741.31 Median $1,071.52 Typical High $1,621.81 | Professional | None | $741.31 | $1,071.52 | $1,621.81 |
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 $467.74 Median $977.24 Typical High $1,348.96 | Professional | 52 · Reduced service | $467.74 | $977.24 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $389.05 Typical High $537.03 | Professional | 53 · Discontinued | $190.55 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,479.11 Typical High $2,041.74 | Professional | 54 · Surgery only | $707.95 | $1,479.11 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $295.12 Typical High $407.38 | Professional | 55 · Aftercare only | $141.25 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $194.98 Typical High $269.15 | Professional | 56 · Pre-op care only | $93.33 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,380.38 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $660.69 | $1,380.38 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,318.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $870.96 | $1,318.26 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $173.78 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,380.38 Typical High $2,187.76 | Professional | 63 · Small infant | $1,174.90 | $1,380.38 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $691.83 | $1,096.48 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $234.42 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $154.88 | $234.42 | $288.40 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $239.88 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $239.88 | $288.40 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $245.47 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $977.24 Typical High $1,348.96 | Professional | 52 · Reduced service | $467.74 | $977.24 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $389.05 Typical High $537.03 | Professional | 53 · Discontinued | $190.55 | $389.05 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,479.11 Typical High $2,041.74 | Professional | 54 · Surgery only | $707.95 | $1,479.11 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $295.12 Typical High $407.38 | Professional | 55 · Aftercare only | $141.25 | $295.12 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $194.98 Typical High $269.15 | Professional | 56 · Pre-op care only | $93.33 | $194.98 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,380.38 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $660.69 | $1,380.38 | $1,905.46 |
Where Idaho sits
The same service costs 5.2 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· 7th of 51
$1,445
AK $3,548UT $676
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.