How much rates vary
Facilitymedian $5,012 · 10th to 90th $891 to $11,482Professionalmedian $513 · 10th to 90th $309 to $851
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 $512.86 Median $1,023.29 Typical High $7,762.47 | Facility | None | $512.86 | $1,023.29 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $851.14 Typical High $851.14 | Professional | None | $281.84 | $851.14 | $851.14 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,467.37 | $5,754.40 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $588.84 | Professional | None | $467.74 | $549.54 | $588.84 |
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 $338.84 Median $398.11 Typical High $478.63 | Professional | None | $338.84 | $398.11 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $6,025.60 Typical High $10,000.00 | Facility | None | $851.14 | $6,025.60 | $10,000.00 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $851.14 | Professional | None | $309.03 | $562.34 | $851.14 |
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 $512.86 Median $512.86 Typical High $5,754.40 | Facility | None | $512.86 | $512.86 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $13,182.57 Typical High $19,054.61 | Facility | None | $6,918.31 | $13,182.57 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | None | $501.19 | $588.84 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $6,606.93 | Facility | None | $239.88 | $245.47 | $6,606.93 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $562.34 | Professional | None | $239.88 | $239.88 | $562.34 |
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 $316.23 Median $407.38 Typical High $616.60 | Professional | None | $316.23 | $407.38 | $616.60 |
25 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 $162.18 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $162.18 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $64.57 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $245.47 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $48.98 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $32.36 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $229.09 | $588.84 | $588.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $489.78 | $512.86 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $57.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 63 · Small infant | $562.34 | $645.65 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $87.10 Typical High $91.20 | Professional | 80 · Assistant surgeon | $75.86 | $87.10 | $91.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $87.10 Typical High $91.20 | Professional | 81 · Minimal assistant surgeon | $75.86 | $87.10 | $91.20 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $75.86 Median $87.10 Typical High $91.20 | Professional | 82 · Assistant surgeon, no resident | $75.86 | $87.10 | $91.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $77.62 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $199.53 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $79.43 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $302.00 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $60.26 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $39.81 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $281.84 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 22 · Increased work | $630.96 | $630.96 | $630.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 63 · Small infant | $630.96 | $630.96 | $630.96 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Where Idaho sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$537
AK $1,202UT $219
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.