How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,514 to $18,621Professionalmedian $1,549 · 10th to 90th $1,072 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 $1,096.48 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $6,606.93 Typical High $18,620.87 | Facility | None | $4,897.79 | $6,606.93 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,659.59 | $1,737.80 |
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 $1,023.29 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,174.90 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $5,495.41 | Facility | None | $954.99 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,737.80 | $2,041.74 |
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 $1,513.56 Typical High $1,513.56 | Facility | None | $1,258.93 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,513.56 | $1,949.84 |
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 $1,548.82 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,737.80 | $2,041.74 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $741.31 Typical High $18,620.87 | Facility | None | $724.44 | $741.31 | $18,620.87 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $4,168.69 | Professional | None | $724.44 | $870.96 | $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 $933.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $933.25 | $1,288.25 | $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 $549.54 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $549.54 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $218.78 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $831.76 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $109.65 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $9,772.37 Typical High $28,183.83 | Facility | 50 · Both sides | $7,413.10 | $9,772.37 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,398.83 Typical High $2,570.40 | Professional | 50 · Both sides | $2,137.96 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $1,905.46 Typical High $2,041.74 | Professional | 63 · Small infant | $1,698.24 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,096.48 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 80 · Assistant surgeon | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | AS · PA/NP assist | $190.55 | $213.80 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $549.54 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $218.78 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $831.76 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $109.65 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 8.1 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
$1,622
AK $3,548TX $437
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.