How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,514 to $9,120Professionalmedian $1,905 · 10th to 90th $1,259 to $2,089
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,737.80 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $9,332.54 | Facility | None | $1,479.11 | $2,951.21 | $9,332.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,235.94 | Facility | None | $2,137.96 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $5,495.41 | Facility | None | $954.99 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,737.80 | $1,905.46 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,949.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,949.84 | $1,949.84 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,760.83 Median $9,120.11 Typical High $11,748.98 | Facility | None | $6,760.83 | $9,120.11 | $11,748.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,949.84 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,265.80 | $5,888.44 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,659.59 | $2,290.87 |
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 $870.96 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $190.55 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,089.30 Median $4,073.80 Typical High $14,791.08 | Facility | 50 · Both sides | $2,089.30 | $4,073.80 | $14,791.08 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,630.27 Typical High $3,019.95 | Professional | 50 · Both sides | $1,778.28 | $2,630.27 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,071.52 | $1,318.26 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $208.93 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $208.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,698.24 Typical High $2,290.87 | Professional | 63 · Small infant | $1,445.44 | $1,698.24 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $302.00 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $302.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $275.42 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $190.55 | $275.42 | $323.59 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $229.09 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $229.09 | $323.59 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $234.42 Typical High $281.84 | Professional | AS · PA/NP assist | $162.18 | $234.42 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $870.96 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $346.74 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $190.55 |
Where Idaho sits
The same service costs 4.8 times more in Alaska than in New York. 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· 16th of 51
$1,950
AK $5,129NY $1,072
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.