How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,660 to $17,378Professionalmedian $1,698 · 10th to 90th $1,175 to $2,089
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 $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $8,317.64 Typical High $18,620.87 | Facility | None | $4,897.79 | $8,317.64 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,819.70 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,318.26 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $5,495.41 | Facility | None | $1,071.52 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,905.46 | $2,238.72 |
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 $1,348.96 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,348.96 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,659.59 | $1,659.59 | $2,089.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,905.46 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $812.83 Typical High $13,489.63 | Facility | None | $794.33 | $812.83 | $13,489.63 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $5,248.07 | Professional | None | $794.33 | $954.99 | $5,248.07 |
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 $1,000.00 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,380.38 | $2,041.74 |
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 $602.56 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $602.56 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $239.88 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $120.23 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $10,232.93 Typical High $28,183.83 | Facility | 50 · Both sides | $7,413.10 | $10,232.93 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,570.40 Typical High $2,818.38 | Professional | 50 · Both sides | $2,290.87 | $2,570.40 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 62 · Two surgeons | $954.99 | $1,071.52 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,862.09 Median $2,089.30 Typical High $2,238.72 | Professional | 63 · Small infant | $1,862.09 | $2,089.30 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 80 · Assistant surgeon | $245.47 | $275.42 | $302.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $245.47 | $275.42 | $302.00 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $275.42 | $302.00 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $234.42 Typical High $257.04 | Professional | AS · PA/NP assist | $208.93 | $234.42 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $602.56 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $239.88 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $120.23 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
Where Idaho sits
The same service costs 7.9 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· 11th of 51
$1,778
AK $3,890TX $490
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.