How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,549 to $14,125Professionalmedian $1,585 · 10th to 90th $1,096 to $1,905
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 $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,698.24 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,230.27 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,778.28 Typical High $5,495.41 | Facility | None | $954.99 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,778.28 | $1,778.28 |
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 $1,258.93 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,258.93 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,548.82 | $1,949.84 |
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 $1,548.82 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,737.80 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $10,471.29 | Facility | None | $741.31 | $758.58 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $3,388.44 | Professional | None | $741.31 | $870.96 | $3,388.44 |
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 $933.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $933.25 | $1,258.93 | $1,862.09 |
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 $562.34 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $229.09 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $851.14 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $7,585.78 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $7,585.78 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,398.83 Typical High $2,630.27 | Professional | 50 · Both sides | $2,137.96 | $2,398.83 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,445.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,288.25 | $1,445.44 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $1,905.46 Typical High $2,089.30 | Professional | 63 · Small infant | $1,698.24 | $1,905.46 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $257.04 Typical High $275.42 | Professional | 80 · Assistant surgeon | $229.09 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $257.04 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $229.09 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $257.04 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | AS · PA/NP assist | $194.98 | $218.78 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $229.09 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $851.14 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,258.93 |
Where Idaho sits
The same service costs 20.9 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· 9th of 51
$1,660
AK $3,467TX $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.