How much rates vary
Facilitymedian $2,239 · 10th to 90th $708 to $8,710Professionalmedian $676 · 10th to 90th $447 to $912
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 $416.87 Median $676.08 Typical High $912.01 | Professional | None | $416.87 | $676.08 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,949.84 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,949.84 | $4,168.69 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $933.25 | Professional | None | $549.54 | $741.31 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $691.83 | Professional | None | $407.38 | $512.86 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $5,495.41 | Facility | None | $275.42 | $676.08 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $912.01 | Professional | None | $489.78 | $741.31 | $912.01 |
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 $575.44 Median $575.44 Typical High $870.96 | Facility | None | $575.44 | $575.44 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,096.48 | Professional | None | $575.44 | $741.31 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $10,471.29 | Facility | None | $5,248.07 | $8,128.31 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,071.52 | Professional | None | $660.69 | $794.33 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $10,471.29 | Facility | None | $416.87 | $416.87 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $1,659.59 | Professional | None | $331.13 | $416.87 | $1,659.59 |
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 $346.74 Median $524.81 Typical High $812.83 | Professional | None | $346.74 | $524.81 | $812.83 |
26 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 $208.93 Median $338.84 Typical High $457.09 | Professional | 52 · Reduced service | $208.93 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $134.90 Typical High $181.97 | Professional | 53 · Discontinued | $83.18 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $309.03 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $100.00 Typical High $138.04 | Professional | 55 · Aftercare only | $61.66 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $67.61 Typical High $91.20 | Professional | 56 · Pre-op care only | $41.69 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $467.74 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $288.40 | $467.74 | $645.65 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $5,888.44 Typical High $14,791.08 | Facility | 50 · Both sides | $2,951.21 | $5,888.44 | $14,791.08 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $933.25 Typical High $1,380.38 | Professional | 50 · Both sides | $794.33 | $933.25 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $478.63 | $724.44 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $97.72 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $97.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | 63 · Small infant | $630.96 | $776.25 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $380.19 | $549.54 | $660.69 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $104.71 Typical High $151.36 | Professional | 80 · Assistant surgeon | $85.11 | $104.71 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $128.82 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $87.10 | $128.82 | $154.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $102.33 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $102.33 | $154.88 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $89.13 Typical High $128.82 | Professional | AS · PA/NP assist | $72.44 | $89.13 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $338.84 Typical High $457.09 | Professional | 52 · Reduced service | $208.93 | $338.84 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $134.90 Typical High $181.97 | Professional | 53 · Discontinued | $83.18 | $134.90 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $309.03 | $501.19 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $100.00 Typical High $138.04 | Professional | 55 · Aftercare only | $61.66 | $100.00 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $67.61 Typical High $91.20 | Professional | 56 · Pre-op care only | $41.69 | $67.61 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $467.74 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $288.40 | $467.74 | $645.65 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,096.48 Typical High $1,513.56 | Professional | 50 · Both sides | $1,096.48 | $1,096.48 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $512.86 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $100.00 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $741.31 |
Where Idaho sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$676
AK $1,622UT $324
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.