How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $3,802Professionalmedian $1,318 · 10th to 90th $933 to $1,585
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 $977.24 Median $1,445.44 Typical High $1,445.44 | Professional | None | $977.24 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $3,890.45 | Facility | None | $3,019.95 | $3,235.94 | $3,890.45 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,380.38 | $1,584.89 |
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 $1,047.13 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,202.26 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,445.44 Typical High $5,495.41 | Facility | None | $676.08 | $1,445.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,621.81 | Professional | None | $977.24 | $1,445.44 | $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 $1,148.15 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 $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $724.44 | Facility | None | $676.08 | $676.08 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,047.13 | Professional | None | $676.08 | $676.08 | $1,047.13 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,698.24 | Professional | None | $812.83 | $1,202.26 | $1,698.24 |
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 $489.78 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $489.78 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $676.08 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $158.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $954.99 Typical High $1,000.00 | Professional | 62 · Two surgeons | $794.33 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,819.70 Typical High $1,905.46 | Professional | 63 · Small infant | $1,548.82 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $204.17 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $218.78 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $489.78 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $144.54 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $676.08 | $1,023.29 | $1,023.29 |
Where Idaho sits
The same service costs 6.3 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
$1,318
AK $3,388UT $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.