How much rates vary
Facilitymedian $2,344 · 10th to 90th $759 to $7,762Professionalmedian $676 · 10th to 90th $457 to $832
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 $426.58 Median $741.31 Typical High $741.31 | Professional | None | $426.58 | $741.31 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $8,128.31 | Facility | None | $2,344.23 | $3,388.44 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $831.76 | Professional | None | $660.69 | $758.58 | $831.76 |
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 $512.86 Median $616.60 Typical High $707.95 | Professional | None | $512.86 | $616.60 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $741.31 Typical High $5,495.41 | Facility | None | $436.52 | $741.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $831.76 | Professional | None | $501.19 | $741.31 | $831.76 |
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 $602.56 Median $741.31 Typical High $741.31 | Facility | None | $602.56 | $741.31 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Professional | None | $741.31 | $741.31 | $1,288.25 |
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 $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $6,309.57 | Facility | None | $354.81 | $354.81 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $537.03 | Professional | None | $354.81 | $354.81 | $537.03 |
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 $407.38 Median $588.84 Typical High $831.76 | Professional | None | $407.38 | $588.84 | $831.76 |
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 $251.19 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $100.00 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $371.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $74.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $50.12 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $346.74 | $524.81 | $524.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $707.95 | $741.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $77.62 | $83.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $512.86 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $512.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $794.33 Median $933.25 Typical High $1,000.00 | Professional | 63 · Small infant | $794.33 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $575.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $125.89 Typical High $131.83 | Professional | 80 · Assistant surgeon | $104.71 | $125.89 | $131.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $125.89 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $104.71 | $125.89 | $131.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $125.89 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $125.89 | $131.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $112.20 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $100.00 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $371.54 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $75.86 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $50.12 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $346.74 | $524.81 | $524.81 |
Where Idaho sits
The same service costs 10.2 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· 18th of 51
$741
OK $2,951UT $288
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.