How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,514 to $7,762Professionalmedian $2,951 · 10th to 90th $2,089 to $3,631
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,137.96 | $3,388.44 | $3,388.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,467.37 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $3,311.31 | Professional | None | $2,691.53 | $3,235.94 | $3,311.31 |
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 $1,862.09 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,290.87 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,621.81 | $3,388.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,137.96 | $3,388.44 | $3,981.07 |
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 $2,398.83 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,398.83 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,951.21 | $2,951.21 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $3,981.07 | Professional | None | $2,818.38 | $3,311.31 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $6,309.57 | Facility | None | $1,412.54 | $1,445.44 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,621.81 | $2,511.89 |
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 $1,698.24 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,398.83 | $3,548.13 |
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 $1,071.52 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,071.52 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $426.58 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,621.81 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $323.59 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $213.80 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,019.95 Median $4,786.30 Typical High $12,589.25 | Facility | 50 · Both sides | $3,019.95 | $4,786.30 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $4,570.88 Typical High $5,011.87 | Professional | 50 · Both sides | $4,073.80 | $4,570.88 | $5,011.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,754.23 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,454.71 | $2,754.23 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $302.00 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $302.00 | $331.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,235.94 Median $3,630.78 Typical High $3,981.07 | Professional | 63 · Small infant | $3,235.94 | $3,630.78 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,137.96 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,137.96 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $489.78 Typical High $524.81 | Professional | 80 · Assistant surgeon | $436.52 | $489.78 | $524.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $436.52 Median $489.78 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $436.52 | $489.78 | $524.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $489.78 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $489.78 | $524.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $416.87 Typical High $446.68 | Professional | AS · PA/NP assist | $371.54 | $416.87 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,071.52 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $426.58 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,621.81 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $323.59 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $213.80 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,398.83 | $2,398.83 |
Where Idaho sits
The same service costs 7.8 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
$2,951
AK $6,761TX $871
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.