How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,318 to $8,913Professionalmedian $1,202 · 10th to 90th $813 to $1,479
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,479.11 | Professional | None | $758.58 | $1,071.52 | $1,479.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $9,120.11 | Facility | None | $2,344.23 | $3,630.78 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,380.38 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,288.25 | Professional | None | $954.99 | $1,096.48 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,479.11 Typical High $5,495.41 | Facility | None | $870.96 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,479.11 | Professional | None | $977.24 | $1,412.54 | $1,479.11 |
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 $1,071.52 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,071.52 | $1,318.26 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,318.26 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,912.51 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,912.51 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $6,456.54 | Facility | None | $630.96 | $645.65 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $954.99 | Professional | None | $630.96 | $630.96 | $954.99 |
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 $776.25 Median $1,096.48 Typical High $1,548.82 | Professional | None | $776.25 | $1,096.48 | $1,548.82 |
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 $436.52 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $436.52 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $177.83 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $660.69 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $131.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $89.13 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $616.60 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,258.93 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $147.91 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | 63 · Small infant | $1,445.44 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $223.87 Typical High $239.88 | Professional | 80 · Assistant surgeon | $190.55 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $223.87 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $190.55 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $223.87 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $204.17 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $489.78 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $194.98 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $691.83 | $1,047.13 | $1,047.13 |
Where Idaho sits
The same service costs 7.9 times more in Oklahoma 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
$1,445
OK $4,169UT $525
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.