How much rates vary
Facilitymedian $977 · 10th to 90th $170 to $5,495Professionalmedian $1,000 · 10th to 90th $724 to $1,413
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 $645.65 Median $1,412.54 Typical High $1,412.54 | Professional | None | $645.65 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,584.89 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,584.89 | $3,162.28 | $9,332.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $891.25 | $1,047.13 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | None | $741.31 | $812.83 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $5,495.41 | Facility | None | $724.44 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $1,412.54 Typical High $1,412.54 | Professional | None | $724.44 | $1,412.54 | $1,412.54 |
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 $794.33 Median $977.24 Typical High $977.24 | Facility | None | $794.33 | $977.24 | $977.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,412.54 | Professional | None | $977.24 | $977.24 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,174.90 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $5,888.44 | Facility | None | $467.74 | $467.74 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $891.25 | Professional | None | $467.74 | $575.44 | $891.25 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,230.27 | Professional | None | $645.65 | $870.96 | $1,230.27 |
19 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 $363.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $363.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $147.91 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $549.54 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $109.65 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $72.44 | $141.25 | $141.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $109.65 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 62 · Two surgeons | $562.34 | $645.65 | $691.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | 63 · Small infant | $1,071.52 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $758.58 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 80 · Assistant surgeon | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $141.25 Typical High $147.91 | Professional | AS · PA/NP assist | $123.03 | $141.25 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $363.08 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $147.91 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $549.54 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $109.65 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $72.44 | $141.25 | $141.25 |
Where Idaho sits
The same service costs 4.9 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· 11th of 51
$1,000
AK $2,399UT $490
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.