How much rates vary
Facilitymedian $1,445 · 10th to 90th $977 to $5,012Professionalmedian $1,096 · 10th to 90th $759 to $1,318
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 $776.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $776.25 | $1,202.26 | $1,202.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,174.90 | $2,630.27 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,174.90 | $1,230.27 |
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 $707.95 Median $812.83 Typical High $933.25 | Professional | None | $707.95 | $812.83 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,202.26 Typical High $5,495.41 | Facility | None | $776.25 | $1,202.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,445.44 | Professional | None | $776.25 | $1,202.26 | $1,445.44 |
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 $891.25 Median $1,096.48 Typical High $1,096.48 | Facility | None | $891.25 | $1,096.48 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,202.26 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $6,309.57 | Facility | None | $524.81 | $537.03 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $977.24 | Professional | None | $524.81 | $602.56 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,258.93 | Professional | None | $645.65 | $891.25 | $1,258.93 |
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 $389.05 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $389.05 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $575.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $77.62 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $537.03 | $851.14 | $851.14 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $3,890.45 Typical High $7,413.10 | Facility | 50 · Both sides | $1,778.28 | $3,890.45 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,698.24 Typical High $1,819.70 | Professional | 50 · Both sides | $1,513.56 | $1,698.24 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $112.20 | $123.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,348.96 Typical High $1,479.11 | Professional | 63 · Small infant | $1,202.26 | $1,348.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $851.14 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 80 · Assistant surgeon | $162.18 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $162.18 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $154.88 Typical High $165.96 | Professional | AS · PA/NP assist | $138.04 | $154.88 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $389.05 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $575.44 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $114.82 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $77.62 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $537.03 | $851.14 | $851.14 |
Where Idaho sits
The same service costs 7.4 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 $2,455TX $331
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.