How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $4,169Professionalmedian $490 · 10th to 90th $316 to $562
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $489.78 | Professional | None | $316.23 | $489.78 | $489.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $446.68 Median $1,202.26 Typical High $4,365.16 | Facility | None | $446.68 | $1,202.26 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $562.34 | Professional | None | $436.52 | $501.19 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $380.19 | Professional | None | $263.03 | $331.13 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $489.78 Typical High $5,495.41 | Facility | None | $245.47 | $489.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $588.84 | Professional | None | $323.59 | $489.78 | $588.84 |
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 $426.58 Median $467.74 Typical High $524.81 | Facility | None | $426.58 | $467.74 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $660.69 | Professional | None | $467.74 | $524.81 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $588.84 | Professional | None | $426.58 | $501.19 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $1,659.59 | Facility | None | $245.47 | $251.19 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $977.24 | Professional | None | $245.47 | $251.19 | $977.24 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $501.19 | Professional | None | $239.88 | $338.84 | $501.19 |
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 $158.49 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $338.84 | $346.74 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $645.65 Median $1,778.28 Typical High $6,760.83 | Facility | 50 · Both sides | $645.65 | $1,778.28 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $758.58 Typical High $831.76 | Professional | 50 · Both sides | $660.69 | $758.58 | $831.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $457.09 | $524.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $56.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $537.03 Median $616.60 Typical High $676.08 | Professional | 63 · Small infant | $537.03 | $616.60 | $676.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $354.81 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $309.03 | $354.81 | $398.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $81.28 Typical High $91.20 | Professional | 80 · Assistant surgeon | $69.18 | $81.28 | $91.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $83.18 Typical High $91.20 | Professional | 81 · Minimal assistant surgeon | $69.18 | $83.18 | $91.20 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $83.18 Typical High $91.20 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $83.18 | $91.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $69.18 Typical High $77.62 | Professional | AS · PA/NP assist | $58.88 | $69.18 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $363.08 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $72.44 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $338.84 | $346.74 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 50 · Both sides | $812.83 | $812.83 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $380.19 | $380.19 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $416.87 |
Where Idaho sits
The same service costs 5.4 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· 7th of 51
$490
AK $1,023UT $191
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.