How much rates vary
Facilitymedian $2,188 · 10th to 90th $794 to $7,244Professionalmedian $724 · 10th to 90th $513 to $891
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 $537.03 Median $794.33 Typical High $794.33 | Professional | None | $537.03 | $794.33 | $794.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $8,128.31 | Facility | None | $1,412.54 | $2,398.83 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $891.25 | Professional | None | $707.95 | $812.83 | $891.25 |
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 $537.03 Median $660.69 Typical High $758.58 | Professional | None | $537.03 | $660.69 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $5,495.41 | Facility | None | $457.09 | $794.33 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $891.25 | Professional | None | $537.03 | $794.33 | $891.25 |
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 $645.65 Median $794.33 Typical High $794.33 | Facility | None | $645.65 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,380.38 | Professional | None | $794.33 | $794.33 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,244.36 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $891.25 | Professional | None | $707.95 | $707.95 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $5,128.61 | Facility | None | $380.19 | $380.19 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $575.44 | Professional | None | $380.19 | $380.19 | $575.44 |
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 $436.52 Median $630.96 Typical High $891.25 | Professional | None | $436.52 | $630.96 | $891.25 |
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 $269.15 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $269.15 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $398.11 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $79.43 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $53.70 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $371.54 | $562.34 | $562.34 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $89.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $1,000.00 Typical High $1,071.52 | Professional | 63 · Small infant | $851.14 | $1,000.00 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $616.60 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $141.25 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $114.82 | $134.90 | $141.25 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $134.90 | $141.25 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $120.23 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $269.15 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $398.11 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $79.43 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $53.70 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $371.54 | $562.34 | $562.34 |
Where Idaho sits
The same service costs 8.9 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· 14th of 51
$794
OK $2,754UT $309
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.