How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,072 to $6,761Professionalmedian $1,072 · 10th to 90th $631 to $1,660
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,659.59 Typical High $1,659.59 | Professional | None | $616.60 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $457.09 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $426.58 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $7,244.36 | Facility | None | $1,778.28 | $2,951.21 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,148.15 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $776.25 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,398.83 | Facility | None | $1,584.89 | $1,778.28 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $933.25 | Professional | None | $660.69 | $812.83 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $5,495.41 | Facility | None | $512.86 | $1,659.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,659.59 | Professional | None | $794.33 | $1,071.52 | $1,659.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $588.84 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $549.54 | $1,148.15 | $1,148.15 |
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 $870.96 Median $1,071.52 Typical High $1,071.52 | Facility | None | $870.96 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | None | $1,071.52 | $1,071.52 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,309.57 Typical High $9,120.11 | Facility | None | $4,786.30 | $6,309.57 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | None | $977.24 | $1,148.15 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $524.81 Typical High $4,786.30 | Facility | None | $512.86 | $524.81 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,047.13 | Professional | None | $512.86 | $512.86 | $1,047.13 |
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 $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
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 $309.03 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $309.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $123.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $93.33 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $61.66 | $165.96 | $165.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $100.00 | $112.20 | $120.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,348.96 Typical High $1,445.44 | Professional | 63 · Small infant | $1,202.26 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 80 · Assistant surgeon | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $165.96 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $398.11 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $158.49 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $120.23 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $79.43 | $165.96 | $165.96 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 22 · Increased work | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 63 · Small infant | $1,202.26 | $1,202.26 | $1,202.26 |
Where Idaho sits
The same service costs 5.5 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
$1,096
AK $2,344TX $427
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.