How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,995 to $13,183Professionalmedian $2,291 · 10th to 90th $1,585 to $3,388
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $4,365.16 | Professional | None | $1,584.89 | $3,388.44 | $4,365.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,162.28 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,511.89 | $3,388.44 |
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 $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,388.44 Typical High $6,165.95 | Facility | None | $1,174.90 | $3,388.44 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $4,365.16 | Professional | None | $1,737.80 | $2,818.38 | $4,365.16 |
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 $2,041.74 Median $2,041.74 Typical High $3,090.30 | Facility | None | $2,041.74 | $2,041.74 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,454.71 | $3,162.28 |
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 $2,238.72 Median $2,398.83 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,398.83 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $10,715.19 | Facility | None | $1,479.11 | $1,513.56 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,479.11 | $1,905.46 |
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 $1,230.27 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,819.70 | $2,691.53 |
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 $794.33 Median $1,698.24 Typical High $2,187.76 | Professional | 52 · Reduced service | $794.33 | $1,698.24 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $676.08 Typical High $870.96 | Professional | 53 · Discontinued | $316.23 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,570.40 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,202.26 | $2,570.40 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $512.86 Typical High $645.65 | Professional | 55 · Aftercare only | $239.88 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $338.84 Typical High $436.52 | Professional | 56 · Pre-op care only | $158.49 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,398.83 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,398.83 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,398.83 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,737.80 | $2,398.83 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $346.74 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $346.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,238.72 Median $2,754.23 Typical High $4,168.69 | Professional | 63 · Small infant | $2,238.72 | $2,754.23 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,862.09 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,862.09 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $363.08 Typical High $549.54 | Professional | 80 · Assistant surgeon | $302.00 | $363.08 | $549.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $363.08 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $302.00 | $363.08 | $562.34 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $363.08 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $363.08 | $549.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $398.11 Typical High $478.63 | Professional | AS · PA/NP assist | $257.04 | $398.11 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,698.24 Typical High $2,187.76 | Professional | 52 · Reduced service | $812.83 | $1,698.24 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $676.08 Typical High $870.96 | Professional | 53 · Discontinued | $323.59 | $676.08 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $2,570.40 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,230.27 | $2,570.40 | $3,235.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $512.86 Typical High $645.65 | Professional | 55 · Aftercare only | $245.47 | $512.86 | $645.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $338.84 Typical High $436.52 | Professional | 56 · Pre-op care only | $162.18 | $338.84 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $2,398.83 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,148.15 | $2,398.83 | $3,019.95 |
Where Idaho sits
The same service costs 5.2 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· 9th of 51
$2,399
AK $6,026TX $1,148
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.