How much rates vary
Facilitymedian $1,122 · 10th to 90th $170 to $5,495Professionalmedian $1,148 · 10th to 90th $851 to $1,660
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 $851.14 Median $1,659.59 Typical High $1,659.59 | Professional | None | $851.14 | $1,659.59 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,819.70 | $3,311.31 | $9,332.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,230.27 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,071.52 | Professional | None | $851.14 | $954.99 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $5,495.41 | Facility | None | $831.76 | $1,659.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $1,659.59 | Professional | None | $851.14 | $1,621.81 | $1,659.59 |
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 $912.01 Median $1,122.02 Typical High $1,122.02 | Facility | None | $912.01 | $1,122.02 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,122.02 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,348.96 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $5,888.44 | Facility | None | $537.03 | $549.54 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,023.29 | Professional | None | $537.03 | $676.08 | $1,023.29 |
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 $758.58 Median $1,023.29 Typical High $1,412.54 | Professional | None | $758.58 | $1,023.29 | $1,412.54 |
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 $426.58 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $426.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $169.82 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $630.96 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $125.89 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $85.11 | $165.96 | $165.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $125.89 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 62 · Two surgeons | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 63 · Small infant | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $190.55 Typical High $204.17 | Professional | 80 · Assistant surgeon | $165.96 | $190.55 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $190.55 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $165.96 | $190.55 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $190.55 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $190.55 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $162.18 Typical High $173.78 | Professional | AS · PA/NP assist | $141.25 | $162.18 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $426.58 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $169.82 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $630.96 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $125.89 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $85.11 | $165.96 | $165.96 |
Where Idaho sits
The same service costs 4.7 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
$1,148
AK $2,754UT $589
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.