How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,072 to $14,125Professionalmedian $891 · 10th to 90th $575 to $1,445
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 $602.56 Median $1,445.44 Typical High $1,445.44 | Professional | None | $602.56 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $446.68 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $416.87 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,248.07 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,000.00 | Professional | None | $794.33 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $831.76 | $870.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $676.08 |
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 $575.44 Median $691.83 Typical High $831.76 | Professional | None | $575.44 | $691.83 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $5,495.41 | Facility | None | $512.86 | $1,445.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,445.44 | Professional | None | $707.95 | $954.99 | $1,445.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $524.81 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $501.19 | $1,023.29 | $1,023.29 |
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 $691.83 Median $851.14 Typical High $851.14 | Facility | None | $691.83 | $851.14 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | None | $851.14 | $851.14 | $977.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
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 $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $10,715.19 | Facility | None | $407.38 | $416.87 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $933.25 | Professional | None | $407.38 | $407.38 | $933.25 |
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 $537.03 Median $707.95 Typical High $1,047.13 | Professional | None | $537.03 | $707.95 | $1,047.13 |
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 $295.12 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $295.12 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $117.49 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $89.13 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $58.88 | $144.54 | $144.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $97.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,096.48 Typical High $1,174.90 | Professional | 63 · Small infant | $954.99 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $154.88 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $147.91 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $125.89 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $147.91 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $123.03 Typical High $131.83 | Professional | AS · PA/NP assist | $107.15 | $123.03 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $354.81 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $141.25 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $107.15 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $70.79 | $144.54 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 22 · Increased work | $1,071.52 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 63 · Small infant | $1,071.52 | $1,071.52 | $1,071.52 |
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· 9th of 51
$912
AK $2,042TX $324
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.