How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,259 to $14,125Professionalmedian $1,259 · 10th to 90th $776 to $2,042
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $2,041.74 Typical High $2,041.74 | Professional | None | $741.31 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $575.44 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $537.03 | $1,412.54 | $1,412.54 |
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 $1,148.15 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $933.25 | $977.24 |
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 $812.83 Median $977.24 Typical High $1,174.90 | Professional | None | $812.83 | $977.24 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $5,495.41 | Facility | None | $741.31 | $2,041.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,348.96 | $2,041.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $758.58 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $707.95 | $1,412.54 | $1,412.54 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,258.93 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
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 $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,412.54 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $10,715.19 | Facility | None | $602.56 | $602.56 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,318.26 | Professional | None | $602.56 | $602.56 | $1,318.26 |
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 $724.44 Median $977.24 Typical High $1,479.11 | Professional | None | $724.44 | $977.24 | $1,479.11 |
17 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 $380.19 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $380.19 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $154.88 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $114.82 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $75.86 | $204.17 | $204.17 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $131.83 | $141.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,584.89 Typical High $1,698.24 | Professional | 63 · Small infant | $1,380.38 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $213.80 Typical High $223.87 | Professional | 80 · Assistant surgeon | $186.21 | $213.80 | $223.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $213.80 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $186.21 | $213.80 | $223.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $213.80 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $213.80 | $223.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $181.97 Typical High $190.55 | Professional | AS · PA/NP assist | $158.49 | $181.97 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $501.19 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $199.53 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $151.36 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $100.00 | $204.17 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 22 · Increased work | $1,513.56 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 63 · Small infant | $1,513.56 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 6.3 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· 10th of 51
$1,318
AK $2,884TX $457
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.