How much rates vary
Facilitymedian $3,715 · 10th to 90th $646 to $12,589Professionalmedian $525 · 10th to 90th $355 to $759
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $758.58 Typical High $977.24 | Professional | None | $338.84 | $758.58 | $977.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $15,135.61 | Facility | None | $2,691.53 | $4,073.80 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $691.83 | Professional | None | $436.52 | $524.81 | $691.83 |
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 $331.13 Median $416.87 Typical High $524.81 | Professional | None | $331.13 | $416.87 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $977.24 Typical High $5,495.41 | Facility | None | $302.00 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $977.24 | Professional | None | $371.54 | $645.65 | $977.24 |
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 $446.68 Median $446.68 Typical High $645.65 | Facility | None | $446.68 | $446.68 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $645.65 | Professional | None | $446.68 | $512.86 | $645.65 |
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 $489.78 Median $524.81 Typical High $660.69 | Professional | None | $489.78 | $524.81 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $5,128.61 | Facility | None | $302.00 | $309.03 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $489.78 | Professional | None | $281.84 | $302.00 | $489.78 |
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 $281.84 Median $398.11 Typical High $645.65 | Professional | None | $281.84 | $398.11 | $645.65 |
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 $173.78 Median $380.19 Typical High $489.78 | Professional | 52 · Reduced service | $173.78 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $151.36 Typical High $194.98 | Professional | 53 · Discontinued | $69.18 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $562.34 Typical High $724.44 | Professional | 54 · Surgery only | $257.04 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $112.20 Typical High $144.54 | Professional | 55 · Aftercare only | $51.29 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $75.86 Typical High $97.72 | Professional | 56 · Pre-op care only | $34.67 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $524.81 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $239.88 | $524.81 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $457.09 Typical High $630.96 | Professional | 54 · Surgery only | $371.54 | $457.09 | $630.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $67.61 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $549.54 Median $602.56 Typical High $776.25 | Professional | 63 · Small infant | $549.54 | $602.56 | $776.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $489.78 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $77.62 Typical High $109.65 | Professional | 80 · Assistant surgeon | $66.07 | $77.62 | $109.65 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $79.43 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $66.07 | $79.43 | $109.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $77.62 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $77.62 | $104.71 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $87.10 Typical High $95.50 | Professional | AS · PA/NP assist | $64.57 | $87.10 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $380.19 Typical High $489.78 | Professional | 52 · Reduced service | $177.83 | $380.19 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $151.36 Typical High $194.98 | Professional | 53 · Discontinued | $70.79 | $151.36 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $562.34 Typical High $724.44 | Professional | 54 · Surgery only | $263.03 | $562.34 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $112.20 Typical High $144.54 | Professional | 55 · Aftercare only | $52.48 | $112.20 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $75.86 Typical High $97.72 | Professional | 56 · Pre-op care only | $35.48 | $75.86 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $524.81 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $245.47 | $524.81 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $354.81 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $64.57 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $489.78 |
Where Idaho sits
The same service costs 8.7 times more in Alaska than in North Dakota. 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.
Physician feeFacility fee
AK $7,504ND $861
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.