How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $3,802Professionalmedian $1,318 · 10th to 90th $977 to $1,660
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 $933.25 Median $1,230.27 Typical High $1,230.27 | Professional | None | $933.25 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $3,388.44 Typical High $4,073.80 | Facility | None | $3,162.28 | $3,388.44 | $4,073.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,445.44 | $1,737.80 |
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 $1,096.48 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,258.93 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,230.27 Typical High $5,495.41 | Facility | None | $707.95 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,548.82 | Professional | None | $977.24 | $1,230.27 | $1,548.82 |
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 $1,230.27 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,230.27 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,380.38 | $1,380.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,047.13 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,096.48 | Professional | None | $707.95 | $707.95 | $1,096.48 |
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 $891.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $891.25 | $1,258.93 | $1,737.80 |
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 $467.74 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $660.69 | $851.14 | $851.14 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,778.28 Typical High $2,089.30 | Professional | 63 · Small infant | $1,584.89 | $1,778.28 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $213.80 | $239.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $239.88 | $281.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $204.17 Typical High $239.88 | Professional | AS · PA/NP assist | $181.97 | $204.17 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $660.69 | $851.14 | $851.14 |
Where Idaho sits
The same service costs 6.6 times more in Alaska than in Texas. 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
$1,230
AK $2,884TX $437
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.