How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,096 to $5,370Professionalmedian $1,622 · 10th to 90th $1,175 to $2,291
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 $1,230.27 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,230.27 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $6,165.95 | Facility | None | $2,041.74 | $3,801.89 | $6,165.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,862.09 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,659.59 | Facility | None | $1,096.48 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,479.11 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $5,495.41 | Facility | None | $1,071.52 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,819.70 | $2,290.87 |
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 $1,445.44 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,445.44 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,778.28 | $1,778.28 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $6,606.93 | Facility | None | $3,467.37 | $5,248.07 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,548.82 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $4,466.84 | Facility | None | $851.14 | $870.96 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,288.25 | Professional | None | $851.14 | $851.14 | $1,288.25 |
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 $1,000.00 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,513.56 | $2,187.76 |
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 $645.65 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $645.65 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $257.04 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $954.99 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $190.55 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $128.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $891.25 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,737.80 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,445.44 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $190.55 | $199.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $1,258.93 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,949.84 Median $2,290.87 Typical High $2,398.83 | Professional | 63 · Small infant | $1,949.84 | $2,290.87 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,348.96 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $645.65 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $257.04 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $977.24 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $194.98 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $128.82 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $912.01 | $1,621.81 | $1,621.81 |
Where Idaho sits
The same service costs 5.9 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· 14th of 51
$1,660
AK $4,074UT $692
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.