How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $3,981Professionalmedian $1,778 · 10th to 90th $1,072 to $2,291
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 $1,000.00 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,000.00 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $3,630.78 Typical High $4,365.16 | Facility | None | $3,388.44 | $3,630.78 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,949.84 | $2,041.74 |
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 $1,174.90 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,380.38 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $2,290.87 Typical High $5,495.41 | Facility | None | $870.96 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,995.26 | $2,290.87 |
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 $1,479.11 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,479.11 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,995.26 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $954.99 | Facility | None | $870.96 | $870.96 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,202.26 | Professional | None | $870.96 | $870.96 | $1,202.26 |
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 $954.99 Median $1,412.54 Typical High $2,089.30 | Professional | None | $954.99 | $1,412.54 | $2,089.30 |
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 $602.56 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $602.56 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $245.47 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $912.01 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $181.97 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $123.03 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $851.14 | $1,584.89 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,698.24 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,479.11 | $1,698.24 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $204.17 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,949.84 Median $2,238.72 Typical High $2,454.71 | Professional | 63 · Small infant | $1,949.84 | $2,238.72 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,318.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $302.00 Typical High $323.59 | Professional | 80 · Assistant surgeon | $263.03 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $302.00 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $263.03 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $302.00 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | AS · PA/NP assist | $223.87 | $257.04 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $602.56 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $245.47 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $912.01 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $181.97 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $123.03 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $851.14 | $1,584.89 | $1,584.89 |
Where Idaho sits
The same service costs 6.8 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· 13th of 51
$1,738
AK $4,074TX $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.