How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,778 to $8,511Professionalmedian $1,820 · 10th to 90th $1,259 to $2,239
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 $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,288.25 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $2,187.76 | $4,897.79 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,949.84 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,380.38 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $5,495.41 | Facility | None | $1,288.25 | $2,041.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,288.25 | $2,041.74 | $2,398.83 |
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 $1,479.11 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,479.11 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,778.28 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $10,715.19 | Facility | None | $5,495.41 | $8,317.64 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,041.74 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $7,943.28 | Facility | None | $851.14 | $870.96 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,862.09 | Professional | None | $851.14 | $1,023.29 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,445.44 | $2,041.74 |
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 $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $645.65 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $257.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $977.24 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $912.01 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $5,888.44 Typical High $14,454.40 | Facility | 50 · Both sides | $3,311.31 | $5,888.44 | $14,454.40 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,818.38 Typical High $3,019.95 | Professional | 50 · Both sides | $2,511.89 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $204.17 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | 63 · Small infant | $1,995.26 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,288.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,288.25 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $295.12 Typical High $323.59 | Professional | 80 · Assistant surgeon | $269.15 | $295.12 | $323.59 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $295.12 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $269.15 | $295.12 | $323.59 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $295.12 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $295.12 | $323.59 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | AS · PA/NP assist | $223.87 | $251.19 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $645.65 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $257.04 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $977.24 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $912.01 | $1,445.44 | $1,445.44 |
Where Idaho sits
The same service costs 8.9 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
$1,862
AK $4,169TX $468
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.