How much rates vary
Facilitymedian $2,138 · 10th to 90th $589 to $7,079Professionalmedian $575 · 10th to 90th $407 to $759
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 $602.56 Median $691.83 Typical High $5,495.41 | Facility | None | $602.56 | $691.83 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $588.84 | Professional | None | $371.54 | $501.19 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,951.21 Typical High $8,128.31 | Facility | None | $1,412.54 | $2,951.21 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $891.25 | Professional | None | $436.52 | $676.08 | $891.25 |
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 $457.09 Median $562.34 Typical High $645.65 | Professional | None | $457.09 | $562.34 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $588.84 Typical High $5,495.41 | Facility | None | $354.81 | $588.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $812.83 | Professional | None | $407.38 | $588.84 | $812.83 |
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 $575.44 Median $575.44 Typical High $741.31 | Facility | None | $575.44 | $575.44 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $741.31 | Professional | None | $575.44 | $630.96 | $741.31 |
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 $436.52 Median $501.19 Typical High $741.31 | Professional | None | $436.52 | $501.19 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $5,128.61 | Facility | None | $380.19 | $389.05 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
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 $389.05 Median $524.81 Typical High $758.58 | Professional | None | $389.05 | $524.81 | $758.58 |
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 $204.17 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $309.03 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $407.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $501.19 | $630.96 | $812.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $93.33 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $851.14 Typical High $1,122.02 | Professional | 63 · Small infant | $660.69 | $851.14 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $489.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $389.05 | $489.78 | $549.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $144.54 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $144.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $109.65 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $93.33 | $109.65 | $144.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $109.65 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $109.65 | $144.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $95.50 Typical High $123.03 | Professional | AS · PA/NP assist | $75.86 | $95.50 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $257.04 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $309.03 | $380.19 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $407.38 |
Where Idaho sits
The same service costs 3.8 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
$603
AK $1,349UT $355
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.