How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $7,586Professionalmedian $437 · 10th to 90th $269 to $708
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $707.95 Typical High $707.95 | Professional | None | $245.47 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $208.93 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $194.98 | $501.19 | $501.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,778.28 Median $3,019.95 Typical High $8,317.64 | Facility | None | $1,778.28 | $3,019.95 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $501.19 | Professional | None | $398.11 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $323.59 | $338.84 |
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 $288.40 Median $338.84 Typical High $398.11 | Professional | None | $288.40 | $338.84 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $1,348.96 Typical High $5,754.40 | Facility | None | $281.84 | $1,348.96 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $707.95 | Professional | None | $275.42 | $478.63 | $707.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $251.19 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $234.42 | $501.19 | $501.19 |
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 $354.81 Median $436.52 Typical High $436.52 | Facility | None | $354.81 | $436.52 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | None | $436.52 | $436.52 | $489.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $338.84 | $338.84 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $363.08 |
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 $426.58 Median $501.19 Typical High $501.19 | Professional | None | $426.58 | $501.19 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $4,897.79 | Facility | None | $208.93 | $208.93 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $467.74 | Professional | None | $208.93 | $208.93 | $467.74 |
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 $263.03 Median $338.84 Typical High $512.86 | Professional | None | $263.03 | $338.84 | $512.86 |
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 $138.04 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $138.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $54.95 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $41.69 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $27.54 | $70.79 | $70.79 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $48.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $478.63 Median $549.54 Typical High $588.84 | Professional | 63 · Small infant | $478.63 | $549.54 | $588.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $74.13 Typical High $77.62 | Professional | 80 · Assistant surgeon | $64.57 | $74.13 | $77.62 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $74.13 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $64.57 | $74.13 | $77.62 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $74.13 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $74.13 | $77.62 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $63.10 Typical High $66.07 | Professional | AS · PA/NP assist | $54.95 | $63.10 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $169.82 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $67.61 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $50.12 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $33.88 | $70.79 | $70.79 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 22 · Increased work | $537.03 | $537.03 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 63 · Small infant | $537.03 | $537.03 | $537.03 |
Where Idaho sits
The same service costs 6.0 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· 11th of 51
$447
AK $1,000UT $166
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.