How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,230 to $17,378Professionalmedian $1,047 · 10th to 90th $708 to $1,288
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 $630.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $630.96 | $1,174.90 | $1,174.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,715.35 Median $5,495.41 Typical High $18,620.87 | Facility | None | $3,715.35 | $5,495.41 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,174.90 | Professional | None | $977.24 | $1,148.15 | $1,174.90 |
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 $660.69 Median $794.33 Typical High $891.25 | Professional | None | $660.69 | $794.33 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $5,495.41 | Facility | None | $616.60 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,380.38 | Professional | None | $741.31 | $1,174.90 | $1,380.38 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
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 $1,047.13 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,174.90 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $9,549.93 | Facility | None | $501.19 | $512.86 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $5,248.07 | Professional | None | $501.19 | $588.84 | $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 $588.84 Median $831.76 Typical High $1,230.27 | Professional | None | $588.84 | $831.76 | $1,230.27 |
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 $371.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $562.34 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $74.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $524.81 | $831.76 | $831.76 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,623.41 Median $7,762.47 Typical High $28,183.83 | Facility | 50 · Both sides | $5,623.41 | $7,762.47 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,621.81 Typical High $1,778.28 | Professional | 50 · Both sides | $1,445.44 | $1,621.81 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $117.49 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,318.26 Typical High $1,412.54 | Professional | 63 · Small infant | $1,174.90 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $831.76 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 80 · Assistant surgeon | $154.88 | $173.78 | $190.55 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $154.88 | $173.78 | $190.55 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $173.78 | $190.55 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | AS · PA/NP assist | $131.83 | $147.91 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $371.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $147.91 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $562.34 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $112.20 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $74.13 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $524.81 | $831.76 | $831.76 |
Where Idaho sits
The same service costs 7.8 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
$1,122
AK $2,399TX $309
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.