How much rates vary
Facilitymedian $2,344 · 10th to 90th $759 to $7,762Professionalmedian $692 · 10th to 90th $490 to $851
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 $512.86 Median $758.58 Typical High $758.58 | Professional | None | $512.86 | $758.58 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $8,128.31 | Facility | None | $1,412.54 | $2,754.23 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $851.14 | Professional | None | $676.08 | $776.25 | $851.14 |
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 $630.96 Typical High $724.44 | Professional | None | $537.03 | $630.96 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $758.58 Typical High $5,495.41 | Facility | None | $446.68 | $758.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $851.14 | Professional | None | $512.86 | $758.58 | $851.14 |
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 $616.60 Median $758.58 Typical High $758.58 | Facility | None | $616.60 | $758.58 | $758.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,318.26 | Professional | None | $758.58 | $758.58 | $1,318.26 |
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 $676.08 Median $676.08 Typical High $851.14 | Professional | None | $676.08 | $676.08 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $5,128.61 | Facility | None | $354.81 | $363.08 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | None | $354.81 | $354.81 | $549.54 |
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 $416.87 Median $645.65 Typical High $891.25 | Professional | None | $416.87 | $645.65 | $891.25 |
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 $257.04 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $257.04 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $75.86 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $51.29 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $354.81 | $537.03 | $537.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $724.44 | $758.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $85.11 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $524.81 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $524.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $812.83 Median $954.99 Typical High $1,000.00 | Professional | 63 · Small infant | $812.83 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $562.34 | $588.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $134.90 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $128.82 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $107.15 | $128.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $128.82 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $128.82 | $134.90 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $114.82 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $257.04 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $102.33 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $75.86 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $51.29 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $354.81 | $537.03 | $537.03 |
Where Idaho sits
The same service costs 7.1 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· 17th of 51
$759
AK $2,042UT $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.