How much rates vary
Facilitymedian $2,344 · 10th to 90th $759 to $7,762Professionalmedian $525 · 10th to 90th $355 to $646
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 $323.59 Median $512.86 Typical High $588.84 | Professional | None | $323.59 | $512.86 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,479.11 Median $2,630.27 Typical High $8,128.31 | Facility | None | $1,479.11 | $2,630.27 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $645.65 | Professional | None | $512.86 | $602.56 | $645.65 |
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 $380.19 Median $489.78 Typical High $549.54 | Professional | None | $380.19 | $489.78 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $5,495.41 | Facility | None | $331.13 | $588.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $645.65 | Professional | None | $398.11 | $588.84 | $645.65 |
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 $467.74 Median $575.44 Typical High $575.44 | Facility | None | $467.74 | $575.44 | $575.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,023.29 | Professional | None | $575.44 | $575.44 | $1,023.29 |
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 $512.86 Median $512.86 Typical High $645.65 | Professional | None | $512.86 | $512.86 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $5,128.61 | Facility | None | $275.42 | $281.84 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | None | $275.42 | $275.42 | $426.58 |
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 $316.23 Median $446.68 Typical High $630.96 | Professional | None | $316.23 | $446.68 | $630.96 |
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 $190.55 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $281.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $263.03 | $407.38 | $407.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $549.54 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $64.57 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $741.31 Typical High $776.25 | Professional | 63 · Small infant | $630.96 | $741.31 | $776.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $104.71 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $104.71 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $97.72 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $83.18 | $97.72 | $104.71 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $97.72 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $97.72 | $104.71 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $83.18 Typical High $89.13 | Professional | AS · PA/NP assist | $70.79 | $83.18 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $194.98 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $77.62 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $58.88 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $275.42 | $407.38 | $407.38 |
Where Idaho sits
The same service costs 11.2 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· 16th of 51
$589
OK $2,512UT $224
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.