How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,698 to $8,511Professionalmedian $1,698 · 10th to 90th $1,175 to $2,089
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,949.84 | $1,949.84 |
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 $1,548.82 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,819.70 | $1,905.46 |
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 $1,122.02 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,318.26 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $5,495.41 | Facility | None | $1,230.27 | $1,949.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,949.84 | $2,290.87 |
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 $1,380.38 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,380.38 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,698.24 | $2,137.96 |
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 $1,621.81 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,905.46 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $7,943.28 | Facility | None | $812.83 | $812.83 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,862.09 | Professional | None | $812.83 | $954.99 | $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 $912.01 Median $1,348.96 Typical High $1,949.84 | Professional | None | $912.01 | $1,348.96 | $1,949.84 |
23 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 $616.60 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $616.60 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $245.47 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $123.03 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
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 $2,344.23 Median $2,630.27 Typical High $2,818.38 | Professional | 50 · Both sides | $2,344.23 | $2,630.27 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $190.55 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 62 · Two surgeons | $977.24 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,862.09 Median $2,089.30 Typical High $2,290.87 | Professional | 63 · Small infant | $1,862.09 | $2,089.30 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 80 · Assistant surgeon | $251.19 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $251.19 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | AS · PA/NP assist | $213.80 | $239.88 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $616.60 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $245.47 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $123.03 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
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· 10th of 51
$1,778
AK $3,890TX $240
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.