How much rates vary
Facilitymedian $1,349 · 10th to 90th $468 to $7,586Professionalmedian $646 · 10th to 90th $407 to $1,072
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 $426.58 Median $870.96 Typical High $1,348.96 | Professional | None | $426.58 | $870.96 | $1,348.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $478.63 Median $1,905.46 Typical High $8,317.64 | Facility | None | $478.63 | $1,905.46 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,071.52 | Professional | None | $549.54 | $676.08 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $676.08 | Facility | None | $436.52 | $489.78 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Professional | None | $371.54 | $489.78 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $870.96 Typical High $4,466.84 | Facility | None | $275.42 | $870.96 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $1,348.96 | Professional | None | $478.63 | $870.96 | $1,348.96 |
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 $575.44 Median $575.44 Typical High $1,000.00 | Facility | None | $575.44 | $575.44 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,000.00 | Professional | None | $575.44 | $645.65 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $10,471.29 | Facility | None | $5,248.07 | $8,128.31 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $954.99 | Professional | None | $575.44 | $645.65 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $478.63 Typical High $5,623.41 | Facility | None | $467.74 | $478.63 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $588.84 | Professional | None | $371.54 | $467.74 | $588.84 |
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 $323.59 Median $489.78 Typical High $794.33 | Professional | None | $323.59 | $489.78 | $794.33 |
23 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 $213.80 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $213.80 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $173.78 Typical High $269.15 | Professional | 53 · Discontinued | $85.11 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $645.65 Typical High $1,023.29 | Professional | 54 · Surgery only | $323.59 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $128.82 Typical High $204.17 | Professional | 55 · Aftercare only | $64.57 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $87.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $42.66 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $602.56 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $302.00 | $602.56 | $954.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $954.99 | Professional | 54 · Surgery only | $478.63 | $562.34 | $954.99 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $53.70 | $95.50 | $107.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $776.25 Typical High $1,288.25 | Professional | 63 · Small infant | $645.65 | $776.25 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $371.54 | $707.95 | $776.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $100.00 Typical High $162.18 | Professional | 80 · Assistant surgeon | $85.11 | $100.00 | $162.18 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $100.00 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $85.11 | $100.00 | $169.82 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $147.91 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $147.91 | $173.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $144.54 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $213.80 | $436.52 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $173.78 Typical High $269.15 | Professional | 53 · Discontinued | $85.11 | $173.78 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $645.65 Typical High $1,023.29 | Professional | 54 · Surgery only | $323.59 | $645.65 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $128.82 Typical High $204.17 | Professional | 55 · Aftercare only | $64.57 | $128.82 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $87.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $42.66 | $87.10 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $602.56 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $302.00 | $602.56 | $954.99 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $645.65 | Professional | 54 · Surgery only | $416.87 | $416.87 | $645.65 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $91.20 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $91.20 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $691.83 |
Where Idaho sits
The same service costs 4.3 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· 10th of 51
$646
AK $1,259KY $295
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.