How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,047 to $6,166Professionalmedian $955 · 10th to 90th $692 to $1,318
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $1,318.26 | Professional | None | $741.31 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $6,456.54 | Facility | None | $2,290.87 | $4,168.69 | $6,456.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,174.90 | Professional | None | $891.25 | $1,071.52 | $1,174.90 |
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 $741.31 Median $851.14 Typical High $1,000.00 | Professional | None | $741.31 | $851.14 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $4,466.84 | Facility | None | $501.19 | $1,318.26 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,318.26 | Professional | None | $758.58 | $1,071.52 | $1,318.26 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,047.13 | $1,778.28 |
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 $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $6,456.54 | Facility | None | $501.19 | $512.86 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $758.58 | Professional | None | $501.19 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,230.27 | Professional | None | $588.84 | $851.14 | $1,230.27 |
21 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 $371.54 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $371.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $147.91 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $549.54 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $109.65 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $74.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $512.86 | $933.25 | $933.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $117.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $724.44 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $724.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 63 · Small infant | $1,122.02 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $776.25 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $158.49 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $371.54 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $151.36 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $562.34 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $112.20 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $75.86 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $524.81 | $933.25 | $933.25 |
Where Idaho sits
The same service costs 5.2 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· 16th of 51
$1,072
AK $2,344UT $447
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.