How much rates vary
Facilitymedian $1,413 · 10th to 90th $759 to $3,311Professionalmedian $1,148 · 10th to 90th $871 to $1,622
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 $891.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $891.25 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $3,311.31 | Facility | None | $2,570.40 | $2,754.23 | $3,311.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,202.26 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,230.27 | Professional | None | $912.01 | $1,047.13 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $5,495.41 | Facility | None | $602.56 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,621.81 | Professional | None | $912.01 | $1,288.25 | $1,621.81 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $630.96 | Facility | None | $602.56 | $602.56 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $912.01 | Professional | None | $602.56 | $602.56 | $912.01 |
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 $724.44 Median $1,023.29 Typical High $1,513.56 | Professional | None | $724.44 | $1,023.29 | $1,513.56 |
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 $446.68 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $446.68 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $177.83 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $676.08 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $134.90 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $89.13 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $630.96 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,202.26 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $141.25 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $851.14 Typical High $891.25 | Professional | 62 · Two surgeons | $707.95 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | 63 · Small infant | $1,380.38 | $1,621.81 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $229.09 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $229.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $213.80 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $181.97 | $213.80 | $229.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $213.80 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $213.80 | $229.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $457.09 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $181.97 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $691.83 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $138.04 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $91.20 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $645.65 | $1,122.02 | $1,122.02 |
Where Idaho sits
The same service costs 5.4 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· 15th of 51
$1,230
AK $2,884UT $537
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.