How much rates vary
Facilitymedian $1,175 · 10th to 90th $575 to $4,169Professionalmedian $933 · 10th to 90th $603 to $1,096
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | None | $645.65 | $1,000.00 | $1,000.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $4,168.69 | Facility | None | $1,174.90 | $1,862.09 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,047.13 | Professional | None | $851.14 | $977.24 | $1,047.13 |
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 $549.54 Median $676.08 Typical High $758.58 | Professional | None | $549.54 | $676.08 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $5,495.41 | Facility | None | $501.19 | $1,000.00 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,202.26 | Professional | None | $645.65 | $1,000.00 | $1,202.26 |
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 $758.58 Median $933.25 Typical High $933.25 | Facility | None | $758.58 | $933.25 | $933.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,174.90 | Professional | None | $933.25 | $933.25 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,202.26 | Professional | None | $870.96 | $1,023.29 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $2,884.03 | Facility | None | $436.52 | $446.68 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $977.24 | Professional | None | $436.52 | $501.19 | $977.24 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,023.29 | Professional | None | $501.19 | $707.95 | $1,023.29 |
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 $323.59 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $128.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $707.95 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $2,570.40 Typical High $6,309.57 | Facility | 50 · Both sides | $1,778.28 | $2,570.40 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,445.44 Typical High $1,548.82 | Professional | 50 · Both sides | $1,288.25 | $1,445.44 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $851.14 | $933.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $104.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,023.29 Median $1,148.15 Typical High $1,230.27 | Professional | 63 · Small infant | $1,023.29 | $1,148.15 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $724.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $151.36 Typical High $165.96 | Professional | 80 · Assistant surgeon | $138.04 | $151.36 | $165.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $151.36 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $138.04 | $151.36 | $165.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $151.36 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $151.36 | $165.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | AS · PA/NP assist | $114.82 | $128.82 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $323.59 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $128.82 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $478.63 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $707.95 |
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· 9th of 51
$955
AK $2,042TX $269
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.