How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,259 to $10,965Professionalmedian $1,259 · 10th to 90th $871 to $1,514
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,445.44 | Professional | None | $870.96 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $12,022.64 | Facility | None | $2,630.27 | $3,890.45 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,380.38 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,096.48 | Professional | None | $870.96 | $977.24 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $5,495.41 | Facility | None | $870.96 | $1,445.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,659.59 | Professional | None | $870.96 | $1,445.44 | $1,659.59 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
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 $1,202.26 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,412.54 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $645.65 | Facility | None | $602.56 | $602.56 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $4,168.69 | Professional | None | $602.56 | $691.83 | $4,168.69 |
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 $794.33 Median $1,096.48 Typical High $1,737.80 | Professional | None | $794.33 | $1,096.48 | $1,737.80 |
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 $436.52 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $173.78 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $645.65 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $128.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $87.10 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $602.56 | $1,000.00 | $1,000.00 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,388.44 Median $6,309.57 Typical High $18,197.01 | Facility | 50 · Both sides | $3,388.44 | $6,309.57 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,949.84 Typical High $2,089.30 | Professional | 50 · Both sides | $1,737.80 | $1,949.84 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $141.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 63 · Small infant | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $173.78 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $645.65 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $128.82 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $87.10 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $602.56 | $1,000.00 | $1,000.00 |
Where Idaho sits
The same service costs 7.2 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· 10th of 51
$1,349
AK $2,884TX $398
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.