How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,318 to $10,965Professionalmedian $3,631 · 10th to 90th $2,570 to $4,467
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $4,168.69 | Professional | None | $2,570.40 | $4,168.69 | $4,168.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,918.31 Median $8,317.64 Typical High $12,022.64 | Facility | None | $6,918.31 | $8,317.64 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,073.80 | Professional | None | $3,235.94 | $3,801.89 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,862.09 | Facility | None | $1,202.26 | $1,348.96 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,818.38 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $4,168.69 Typical High $6,025.60 | Facility | None | $1,659.59 | $4,168.69 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $4,897.79 | Professional | None | $2,570.40 | $4,168.69 | $4,897.79 |
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 $2,884.03 Median $3,548.13 Typical High $3,548.13 | Facility | None | $2,884.03 | $3,548.13 | $3,548.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,466.84 | Professional | None | $3,548.13 | $3,548.13 | $4,466.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $4,897.79 | Professional | None | $3,467.37 | $4,073.80 | $4,897.79 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,778.28 | Facility | None | $1,659.59 | $1,659.59 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,659.59 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,238.72 | $3,090.30 | $4,466.84 |
23 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 $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,288.25 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,949.84 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $389.05 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $257.04 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $9,772.37 Median $12,589.25 Typical High $18,197.01 | Facility | 50 · Both sides | $9,772.37 | $12,589.25 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $5,495.41 Typical High $5,888.44 | Professional | 50 · Both sides | $4,897.79 | $5,495.41 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,311.31 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,951.21 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 55 · Aftercare only | $323.59 | $363.08 | $398.11 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $2,290.87 Typical High $2,454.71 | Professional | 62 · Two surgeons | $2,041.74 | $2,290.87 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,890.45 Median $4,365.16 Typical High $4,786.30 | Professional | 63 · Small infant | $3,890.45 | $4,365.16 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,570.40 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,570.40 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $588.84 Typical High $630.96 | Professional | 80 · Assistant surgeon | $524.81 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $524.81 Median $588.84 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $524.81 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $524.81 Median $588.84 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $524.81 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | AS · PA/NP assist | $446.68 | $501.19 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,288.25 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $524.81 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,949.84 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $389.05 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $257.04 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,884.03 | $2,884.03 |
Where Idaho sits
The same service costs 19.5 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· 11th of 51
$3,631
AK $8,318TX $427
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.