How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,413 to $16,218Professionalmedian $1,380 · 10th to 90th $977 to $1,698
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 $977.24 Median $1,584.89 Typical High $1,584.89 | Professional | None | $977.24 | $1,584.89 | $1,584.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,884.03 Median $5,248.07 Typical High $18,620.87 | Facility | None | $2,884.03 | $5,248.07 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,513.56 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,202.26 | Professional | None | $912.01 | $1,071.52 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $2,238.72 Typical High $8,511.38 | Facility | None | $977.24 | $2,238.72 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $1,862.09 | Professional | None | $977.24 | $1,584.89 | $1,862.09 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,122.02 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,380.38 | $1,737.80 |
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 $1,412.54 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,548.82 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $6,918.31 | Facility | None | $660.69 | $676.08 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $4,168.69 | Professional | None | $660.69 | $776.25 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,659.59 | Professional | None | $831.76 | $1,122.02 | $1,659.59 |
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 $489.78 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $489.78 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $741.31 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $97.72 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $691.83 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,168.69 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $4,168.69 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,137.96 Typical High $2,344.23 | Professional | 50 · Both sides | $1,905.46 | $2,137.96 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $154.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,698.24 Typical High $1,862.09 | Professional | 63 · Small infant | $1,513.56 | $1,698.24 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 80 · Assistant surgeon | $204.17 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $204.17 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | AS · PA/NP assist | $173.78 | $194.98 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $489.78 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $741.31 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $147.91 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $97.72 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $691.83 | $1,096.48 | $1,096.48 |
Where Idaho sits
The same service costs 7.6 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· 11th of 51
$1,479
AK $3,162TX $417
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.