How much rates vary
Facilitymedian $676 · 10th to 90th $437 to $1,995Professionalmedian $603 · 10th to 90th $457 to $794
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | None | $426.58 | $588.84 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,445.44 | $1,513.56 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $831.76 | Professional | None | $501.19 | $691.83 | $831.76 |
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 $501.19 Median $616.60 Typical High $691.83 | Professional | None | $501.19 | $616.60 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $5,495.41 | Facility | None | $457.09 | $588.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $776.25 | Professional | None | $478.63 | $588.84 | $776.25 |
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 $588.84 Median $676.08 Typical High $676.08 | Facility | None | $588.84 | $676.08 | $676.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | None | $630.96 | $676.08 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $831.76 | Professional | None | $501.19 | $501.19 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Facility | None | $346.74 | $346.74 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $524.81 | Professional | None | $346.74 | $346.74 | $524.81 |
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 $407.38 Median $549.54 Typical High $794.33 | Professional | None | $407.38 | $549.54 | $794.33 |
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 $208.93 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $316.23 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $295.12 | $407.38 | $407.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $645.65 | $758.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $83.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $758.58 Median $851.14 Typical High $1,000.00 | Professional | 63 · Small infant | $758.58 | $851.14 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $588.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $114.82 Typical High $134.90 | Professional | 80 · Assistant surgeon | $102.33 | $114.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $114.82 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $102.33 | $114.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $114.82 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $114.82 | $134.90 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $97.72 Typical High $114.82 | Professional | AS · PA/NP assist | $87.10 | $97.72 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $407.38 |
Where Idaho sits
The same service costs 6.0 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· 18th of 51
$631
AK $1,380UT $229
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.