How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $6,026Professionalmedian $2,818 · 10th to 90th $1,738 to $3,631
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 $1,905.46 Median $3,630.78 Typical High $3,630.78 | Professional | None | $1,905.46 | $3,630.78 | $3,630.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,495.41 Median $5,754.40 Typical High $7,079.46 | Facility | None | $5,495.41 | $5,754.40 | $7,079.46 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,162.28 | Professional | None | $2,570.40 | $3,019.95 | $3,162.28 |
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 $1,862.09 Median $2,187.76 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,187.76 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $3,630.78 Typical High $5,495.41 | Facility | None | $1,318.26 | $3,630.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $3,630.78 | Professional | None | $1,905.46 | $3,090.30 | $3,630.78 |
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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,818.38 | $2,818.38 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $3,548.13 | Professional | None | $2,630.27 | $3,162.28 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Facility | None | $1,318.26 | $1,318.26 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,318.26 | $1,905.46 |
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 $1,548.82 Median $2,290.87 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,290.87 | $3,311.31 |
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 $954.99 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $954.99 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $380.19 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,445.44 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $288.40 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $190.55 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,570.40 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,238.72 | $2,570.40 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $316.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,019.95 Median $3,467.37 Typical High $3,715.35 | Professional | 63 · Small infant | $3,019.95 | $3,467.37 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,995.26 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 80 · Assistant surgeon | $398.11 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $398.11 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $389.05 Typical High $426.58 | Professional | AS · PA/NP assist | $338.84 | $389.05 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $954.99 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $380.19 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,445.44 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $288.40 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $190.55 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,511.89 | $2,511.89 |
Where Idaho sits
The same service costs 7.2 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· 12th of 51
$2,692
AK $6,457TX $891
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.