How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,202 to $13,183Professionalmedian $3,467 · 10th to 90th $2,512 to $4,571
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 Professional Modifier None Typical Low $2,187.76 Median $3,630.78 Typical High $4,365.16 | Professional | None | $2,187.76 | $3,630.78 | $4,365.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $15,135.61 | Facility | None | $1,258.93 | $5,128.61 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,754.23 Median $3,801.89 Typical High $4,677.35 | Professional | None | $2,754.23 | $3,801.89 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,621.81 | Facility | None | $1,071.52 | $1,202.26 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,818.38 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $5,248.07 | Facility | None | $2,041.74 | $3,630.78 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,365.16 | Professional | None | $2,511.89 | $3,630.78 | $4,365.16 |
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 $3,019.95 Median $3,019.95 Typical High $4,265.80 | Facility | None | $3,019.95 | $3,019.95 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,019.95 Median $3,890.45 Typical High $5,370.32 | Professional | None | $3,019.95 | $3,890.45 | $5,370.32 |
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 $3,467.37 Median $4,265.80 Typical High $5,128.61 | Professional | None | $3,467.37 | $4,265.80 | $5,128.61 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $10,471.29 | Facility | None | $2,041.74 | $2,089.30 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,096.48 | $2,041.74 | $2,754.23 |
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 $2,041.74 Median $3,090.30 Typical High $4,570.88 | Professional | None | $2,041.74 | $3,090.30 | $4,570.88 |
24 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 $1,096.48 Median $1,819.70 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,096.48 | $1,819.70 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $724.44 Typical High $870.96 | Professional | 53 · Discontinued | $436.52 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $549.54 Typical High $660.69 | Professional | 55 · Aftercare only | $331.13 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $363.08 Typical High $436.52 | Professional | 56 · Pre-op care only | $218.78 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $3,090.30 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,905.46 Median $7,762.47 Typical High $22,908.68 | Facility | 50 · Both sides | $1,905.46 | $7,762.47 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $4,265.80 Median $4,897.79 Typical High $7,079.46 | Professional | 50 · Both sides | $4,265.80 | $4,897.79 | $7,079.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,548.13 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,511.89 | $3,548.13 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $331.13 Typical High $457.09 | Professional | 55 · Aftercare only | $275.42 | $331.13 | $457.09 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,890.45 Typical High $5,623.41 | Professional | 63 · Small infant | $3,311.31 | $3,890.45 | $5,623.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,691.53 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,691.53 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $616.60 Typical High $741.31 | Professional | 80 · Assistant surgeon | $457.09 | $616.60 | $741.31 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $446.68 Median $537.03 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $446.68 | $537.03 | $758.58 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $537.03 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $537.03 | $758.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $446.68 Typical High $616.60 | Professional | AS · PA/NP assist | $380.19 | $446.68 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,819.70 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,096.48 | $1,819.70 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $724.44 Typical High $870.96 | Professional | 53 · Discontinued | $436.52 | $724.44 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $549.54 Typical High $660.69 | Professional | 55 · Aftercare only | $331.13 | $549.54 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $363.08 Typical High $436.52 | Professional | 56 · Pre-op care only | $218.78 | $363.08 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $5,888.44 Median $5,888.44 Typical High $7,079.46 | Professional | 50 · Both sides | $5,888.44 | $5,888.44 | $7,079.46 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,754.23 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,754.23 | $2,754.23 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $3,548.13 |
Where Idaho sits
The same service costs 5.5 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· 9th of 51
$3,467
AK $6,918TX $1,259
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.