How much rates vary
Facilitymedian $2,138 · 10th to 90th $550 to $9,120Professionalmedian $4,467 · 10th to 90th $2,754 to $5,888
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 $2,570.40 Median $5,888.44 Typical High $5,888.44 | Professional | None | $2,570.40 | $5,888.44 | $5,888.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,244.36 Median $8,709.64 Typical High $10,964.78 | Facility | None | $7,244.36 | $8,709.64 | $10,964.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,128.61 | Professional | None | $4,073.80 | $4,786.30 | $5,128.61 |
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 $3,019.95 Median $3,548.13 Typical High $4,073.80 | Professional | None | $3,019.95 | $3,548.13 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $2,137.96 Median $5,495.41 Typical High $8,317.64 | Facility | None | $2,137.96 | $5,495.41 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,897.79 Typical High $5,888.44 | Professional | None | $3,090.30 | $4,897.79 | $5,888.44 |
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 $3,630.78 Median $4,466.84 Typical High $4,466.84 | Facility | None | $3,630.78 | $4,466.84 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,623.41 | Professional | None | $4,466.84 | $4,466.84 | $5,623.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $5,754.40 | Professional | None | $4,365.16 | $5,128.61 | $5,754.40 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,344.23 | Facility | None | $2,137.96 | $2,137.96 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,137.96 | $3,090.30 |
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 $2,187.76 Median $3,019.95 Typical High $5,248.07 | Professional | None | $2,187.76 | $3,019.95 | $5,248.07 |
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 $1,288.25 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $1,288.25 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $524.81 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,949.84 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $389.05 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $257.04 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,819.70 | $4,073.80 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $4,168.69 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,630.78 | $4,168.69 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 55 · Aftercare only | $398.11 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,786.30 Median $5,495.41 Typical High $6,025.60 | Professional | 63 · Small infant | $4,786.30 | $5,495.41 | $6,025.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,235.94 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,235.94 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 80 · Assistant surgeon | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $630.96 Typical High $676.08 | Professional | AS · PA/NP assist | $549.54 | $630.96 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $1,548.82 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $616.60 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,344.23 | $4,365.16 | $4,365.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $467.74 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $309.03 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,187.76 | $4,073.80 | $4,073.80 |
Where Idaho sits
The same service costs 17.4 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· 11th of 51
$4,266
AK $10,471TX $603
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.