How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,660 to $20,417Professionalmedian $1,660 · 10th to 90th $1,148 to $2,042
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,884.03 Median $5,248.07 Typical High $23,988.33 | Facility | None | $2,884.03 | $5,248.07 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,778.28 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $10,471.29 Median $11,748.98 Typical High $15,848.93 | Facility | None | $10,471.29 | $11,748.98 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,288.25 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $5,495.41 | Facility | None | $776.25 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,174.90 | $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 $14,791.08 Median $19,498.45 Typical High $24,547.09 | Facility | None | $14,791.08 | $19,498.45 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,862.09 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $831.76 | Facility | None | $776.25 | $776.25 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $10,715.19 | Professional | None | $776.25 | $933.25 | $10,715.19 |
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 $831.76 Median $1,230.27 Typical High $1,819.70 | Professional | None | $831.76 | $1,230.27 | $1,819.70 |
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 $588.84 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $588.84 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $239.88 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $891.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $117.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,365.16 Median $8,317.64 Typical High $35,481.34 | Facility | 50 · Both sides | $4,365.16 | $8,317.64 | $35,481.34 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,570.40 Typical High $2,754.23 | Professional | 50 · Both sides | $2,290.87 | $2,570.40 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $186.21 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,819.70 Median $2,041.74 Typical High $2,187.76 | Professional | 63 · Small infant | $1,819.70 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 80 · Assistant surgeon | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $251.19 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $588.84 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $239.88 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $891.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $177.83 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $117.49 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,318.26 | $1,318.26 |
Where Idaho sits
The same service costs 16.2 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· 9th of 51
$1,698
AK $3,802TX $234
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.