How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,413 to $12,303Professionalmedian $1,259 · 10th to 90th $933 to $1,778
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,737.80 Median $4,466.84 Typical High $13,489.63 | Facility | None | $1,737.80 | $4,466.84 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,445.44 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $4,570.88 | Facility | None | $3,019.95 | $3,388.44 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,148.15 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,778.28 Typical High $5,495.41 | Facility | None | $776.25 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,513.56 | $1,778.28 |
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 $1,148.15 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,148.15 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,412.54 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,982.44 | Facility | None | $8,511.38 | $12,302.69 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,202.26 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $5,623.41 | Facility | None | $676.08 | $676.08 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,023.29 | Professional | None | $676.08 | $676.08 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $776.25 | $1,122.02 | $1,659.59 |
20 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 $489.78 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $489.78 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $199.53 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $741.31 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $147.91 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $100.00 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $691.83 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,778.28 Typical High $1,905.46 | Professional | 63 · Small infant | $1,513.56 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $239.88 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $204.17 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $239.88 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $213.80 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $501.19 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $204.17 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $758.58 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $151.36 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $100.00 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $707.95 | $1,258.93 | $1,258.93 |
Where Idaho sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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.
Physician feeFacility fee
OK $9,757HI $1,932
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.