How much rates vary
Facilitymedian $398 · 10th to 90th $158 to $851Professionalmedian $741 · 10th to 90th $479 to $891
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 $467.74 Median $741.31 Typical High $812.83 | Professional | None | $467.74 | $741.31 | $812.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $398.11 Typical High $707.95 | Facility | None | $181.97 | $398.11 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $933.25 | Professional | None | $645.65 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $616.60 | Professional | None | $436.52 | $549.54 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $5,495.41 | Facility | None | $371.54 | $794.33 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $891.25 | Professional | None | $524.81 | $741.31 | $891.25 |
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 $691.83 Median $707.95 Typical High $851.14 | Facility | None | $691.83 | $707.95 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,071.52 | Professional | None | $707.95 | $851.14 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $954.99 | Professional | None | $707.95 | $831.76 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $912.01 | Facility | None | $407.38 | $416.87 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $407.38 Typical High $575.44 | Professional | None | $151.36 | $407.38 | $575.44 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $758.58 | Professional | None | $380.19 | $524.81 | $758.58 |
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 $239.88 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $239.88 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $95.50 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $47.86 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $524.81 | $562.34 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $269.15 Median $575.44 Typical High $1,071.52 | Facility | 50 · Both sides | $269.15 | $575.44 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,174.90 Typical High $1,412.54 | Professional | 50 · Both sides | $977.24 | $1,174.90 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $691.83 | $831.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $95.50 | Professional | 55 · Aftercare only | $64.57 | $79.43 | $95.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $954.99 Typical High $1,122.02 | Professional | 63 · Small infant | $776.25 | $954.99 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $630.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $154.88 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $154.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $125.89 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $107.15 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $125.89 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $125.89 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $125.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $239.88 | $371.54 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $95.50 | $147.91 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $562.34 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $112.20 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $47.86 | $74.13 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $524.81 | $562.34 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | 50 · Both sides | $1,230.27 | $1,230.27 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $575.44 | $630.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $91.20 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $676.08 |
Where Idaho sits
The same service costs 5.2 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· 8th of 51
$741
AK $1,514TX $288
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.