How much rates vary
Facilitymedian $1,862 · 10th to 90th $794 to $3,890Professionalmedian $891 · 10th to 90th $617 to $1,072
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | None | $645.65 | $977.24 | $977.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,862.09 | $2,041.74 | $2,754.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,096.48 | Professional | None | $851.14 | $933.25 | $1,096.48 |
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 $691.83 Median $812.83 Typical High $954.99 | Professional | None | $691.83 | $812.83 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $977.24 Typical High $5,495.41 | Facility | None | $562.34 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,071.52 | Professional | None | $645.65 | $977.24 | $1,071.52 |
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 $794.33 Median $977.24 Typical High $977.24 | Facility | None | $794.33 | $977.24 | $977.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | None | $977.24 | $977.24 | $1,148.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | None | $851.14 | $851.14 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Facility | None | $467.74 | $467.74 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None | $467.74 | $467.74 | $707.95 |
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 $537.03 Median $758.58 Typical High $1,071.52 | Professional | None | $537.03 | $758.58 | $1,071.52 |
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 $323.59 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $676.08 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $109.65 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $660.69 Typical High $691.83 | Professional | 62 · Two surgeons | $549.54 | $660.69 | $691.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,071.52 Median $1,258.93 Typical High $1,318.26 | Professional | 63 · Small infant | $1,071.52 | $1,258.93 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $776.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $169.82 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $141.25 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $169.82 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $151.36 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $676.08 | $676.08 |
Where Idaho sits
The same service costs 6.0 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· 12th of 51
$977
AK $2,239UT $372
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.