How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,202 to $7,244Professionalmedian $1,380 · 10th to 90th $1,096 to $1,698
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 $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $7,413.10 | Facility | None | $1,698.24 | $3,162.28 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,479.11 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,380.38 | Professional | None | $977.24 | $1,230.27 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $5,495.41 | Facility | None | $851.14 | $1,348.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
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 $1,148.15 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,148.15 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,513.56 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,380.38 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $4,265.80 | Facility | None | $741.31 | $758.58 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Professional | None | $741.31 | $741.31 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,621.81 | Professional | None | $891.25 | $1,174.90 | $1,621.81 |
22 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 $616.60 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $933.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,511.89 Median $4,265.80 Typical High $11,220.18 | Facility | 50 · Both sides | $2,511.89 | $4,265.80 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,238.72 Typical High $2,630.27 | Professional | 50 · Both sides | $2,041.74 | $2,238.72 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,621.81 Median $1,819.70 Typical High $2,089.30 | Professional | 63 · Small infant | $1,621.81 | $1,819.70 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $213.80 | $239.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $239.88 | $281.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $204.17 Typical High $239.88 | Professional | AS · PA/NP assist | $181.97 | $204.17 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $933.25 |
Where Idaho sits
The same service costs 7.6 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· 17th of 51
$1,380
AK $3,631TX $479
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.