How much rates vary
Facilitymedian $2,138 · 10th to 90th $389 to $8,511Professionalmedian $275 · 10th to 90th $195 to $525
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 $181.97 Median $239.88 Typical High $416.87 | Professional | None | $181.97 | $239.88 | $416.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,137.96 | $3,801.89 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $616.60 | Professional | None | $218.78 | $416.87 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,737.80 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $446.68 | Professional | None | $199.53 | $269.15 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $389.05 Typical High $5,495.41 | Facility | None | $181.97 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $524.81 | Professional | None | $208.93 | $323.59 | $524.81 |
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 $223.87 Median $223.87 Typical High $524.81 | Facility | None | $223.87 | $223.87 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $426.58 Typical High $562.34 | Professional | None | $223.87 | $426.58 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,709.64 Typical High $12,589.25 | Facility | None | $6,165.95 | $8,709.64 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $478.63 | Professional | None | $218.78 | $288.40 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $6,025.60 | Facility | None | $269.15 | $275.42 | $6,025.60 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $338.84 | Professional | None | $154.88 | $269.15 | $338.84 |
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 $158.49 Median $269.15 Typical High $512.86 | Professional | None | $158.49 | $269.15 | $512.86 |
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 $91.20 Median $107.15 Typical High $208.93 | Professional | 52 · Reduced service | $91.20 | $107.15 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $83.18 | Professional | 53 · Discontinued | $36.31 | $42.66 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $316.23 | Professional | 54 · Surgery only | $138.04 | $162.18 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $63.10 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $41.69 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $41.69 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,235.94 Median $5,754.40 Typical High $14,791.08 | Facility | 50 · Both sides | $3,235.94 | $5,754.40 | $14,791.08 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $398.11 Typical High $954.99 | Professional | 50 · Both sides | $338.84 | $398.11 | $954.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $562.34 | Professional | 54 · Surgery only | $204.17 | $245.47 | $562.34 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $46.77 Typical High $63.10 | Professional | 55 · Aftercare only | $22.39 | $46.77 | $63.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $269.15 Median $316.23 Typical High $645.65 | Professional | 63 · Small infant | $269.15 | $316.23 | $645.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $426.58 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $43.65 Typical High $97.72 | Professional | 80 · Assistant surgeon | $36.31 | $43.65 | $97.72 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $75.86 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $36.31 | $75.86 | $97.72 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $43.65 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $43.65 | $93.33 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $58.88 Typical High $83.18 | Professional | AS · PA/NP assist | $30.90 | $58.88 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $107.15 Typical High $208.93 | Professional | 52 · Reduced service | $91.20 | $107.15 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $83.18 | Professional | 53 · Discontinued | $36.31 | $42.66 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $316.23 | Professional | 54 · Surgery only | $138.04 | $162.18 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $63.10 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $41.69 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $41.69 |
Where Idaho sits
The same service costs 5.8 times more in Alaska than in Hawaii. 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· 9th of 51
$417
AK $955HI $166
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.