How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,622 to $14,125Professionalmedian $955 · 10th to 90th $309 to $5,248
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 $234.42 Median $2,818.38 Typical High $5,128.61 | Professional | None | $234.42 | $2,818.38 | $5,128.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $6,918.31 Typical High $17,782.79 | Facility | None | $5,888.44 | $6,918.31 | $17,782.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $371.54 Median $3,890.45 Typical High $5,623.41 | Professional | None | $371.54 | $3,890.45 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $5,370.32 Typical High $7,244.36 | Facility | None | $4,786.30 | $5,370.32 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $4,786.30 | Professional | None | $338.84 | $512.86 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $5,128.61 Typical High $9,772.37 | Facility | None | $436.52 | $5,128.61 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $2,884.03 Typical High $5,128.61 | Professional | None | $309.03 | $2,884.03 | $5,128.61 |
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 $371.54 Median $371.54 Typical High $4,786.30 | Facility | None | $371.54 | $371.54 | $4,786.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $954.99 Typical High $5,128.61 | Professional | None | $346.74 | $954.99 | $5,128.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $4,677.35 | Professional | None | $371.54 | $489.78 | $4,677.35 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,454.71 | $2,454.71 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $2,454.71 Typical High $3,311.31 | Professional | None | $251.19 | $2,454.71 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $275.42 Median $2,818.38 Typical High $6,025.60 | Professional | None | $275.42 | $2,818.38 | $6,025.60 |
18 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 $154.88 Median $218.78 Typical High $2,570.40 | Professional | 52 · Reduced service | $154.88 | $218.78 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $87.10 Typical High $1,023.29 | Professional | 53 · Discontinued | $61.66 | $87.10 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $323.59 Typical High $3,890.45 | Professional | 54 · Surgery only | $229.09 | $323.59 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $776.25 | Professional | 55 · Aftercare only | $45.71 | $64.57 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $43.65 Typical High $512.86 | Professional | 56 · Pre-op care only | $30.90 | $43.65 | $512.86 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $416.87 Typical High $5,011.87 | Professional | 54 · Surgery only | $323.59 | $416.87 | $5,011.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $524.81 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $524.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $6,165.95 Typical High $6,918.31 | Professional | 63 · Small infant | $446.68 | $6,165.95 | $6,918.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $316.23 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $257.04 | $316.23 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $74.13 Typical High $933.25 | Professional | 80 · Assistant surgeon | $58.88 | $74.13 | $933.25 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $707.95 Typical High $891.25 | Professional | 81 · Minimal assistant surgeon | $58.88 | $707.95 | $891.25 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $630.96 Typical High $933.25 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $630.96 | $933.25 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $630.96 Typical High $776.25 | Professional | AS · PA/NP assist | $56.23 | $630.96 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $218.78 Typical High $2,570.40 | Professional | 52 · Reduced service | $154.88 | $218.78 | $2,570.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $87.10 Typical High $1,023.29 | Professional | 53 · Discontinued | $61.66 | $87.10 | $1,023.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $323.59 Typical High $3,890.45 | Professional | 54 · Surgery only | $229.09 | $323.59 | $3,890.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $776.25 | Professional | 55 · Aftercare only | $45.71 | $64.57 | $776.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $43.65 Typical High $512.86 | Professional | 56 · Pre-op care only | $30.90 | $43.65 | $512.86 |
Where Idaho sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 8th of 51
$3,548
AK $5,248NE $468
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.