How much rates vary
Facilitymedian $1,820 · 10th to 90th $562 to $7,079Professionalmedian $741 · 10th to 90th $490 to $1,148
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $1,047.13 Typical High $1,584.89 | Professional | None | $489.78 | $1,047.13 | $1,584.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $2,344.23 Typical High $8,317.64 | Facility | None | $1,202.26 | $2,344.23 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,148.15 | Professional | None | $602.56 | $758.58 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $831.76 | Professional | None | $457.09 | $588.84 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,047.13 Typical High $5,495.41 | Facility | None | $371.54 | $1,047.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,584.89 | Professional | None | $524.81 | $1,047.13 | $1,584.89 |
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 $616.60 Median $616.60 Typical High $1,047.13 | Facility | None | $616.60 | $616.60 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,071.52 | Professional | None | $616.60 | $707.95 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,096.48 | Professional | None | $691.83 | $758.58 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $4,897.79 | Facility | None | $501.19 | $512.86 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $691.83 | Professional | None | $398.11 | $501.19 | $691.83 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $933.25 | Professional | None | $380.19 | $549.54 | $933.25 |
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 $245.47 Median $512.86 Typical High $794.33 | Professional | 52 · Reduced service | $245.47 | $512.86 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $208.93 Typical High $316.23 | Professional | 53 · Discontinued | $97.72 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $776.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $363.08 | $776.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $154.88 Typical High $239.88 | Professional | 55 · Aftercare only | $74.13 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $104.71 Typical High $158.49 | Professional | 56 · Pre-op care only | $48.98 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $338.84 | $724.44 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $512.86 | $977.24 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $64.57 | $93.33 | $107.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $1,148.15 Typical High $1,380.38 | Professional | 63 · Small infant | $691.83 | $1,148.15 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $416.87 | $676.08 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $173.78 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $173.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $107.15 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $91.20 | $107.15 | $181.97 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $112.20 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $112.20 | $177.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $95.50 Typical High $154.88 | Professional | AS · PA/NP assist | $77.62 | $95.50 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $512.86 Typical High $794.33 | Professional | 52 · Reduced service | $245.47 | $512.86 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $208.93 Typical High $316.23 | Professional | 53 · Discontinued | $97.72 | $208.93 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $776.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $363.08 | $776.25 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $154.88 Typical High $239.88 | Professional | 55 · Aftercare only | $74.13 | $154.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $104.71 Typical High $158.49 | Professional | 56 · Pre-op care only | $48.98 | $104.71 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $338.84 | $724.44 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | 54 · Surgery only | $489.78 | $489.78 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $107.15 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $107.15 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $794.33 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in New Jersey. 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· 11th of 51
$741
AK $1,445NJ $389
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.