How much rates vary
Facilitymedian $2,188 · 10th to 90th $676 to $7,762Professionalmedian $2,754 · 10th to 90th $1,905 to $3,388
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,995.26 | $3,162.28 | $3,162.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $8,511.38 | Facility | None | $1,258.93 | $2,290.87 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,090.30 | Professional | None | $2,570.40 | $3,019.95 | $3,090.30 |
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 $1,737.80 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,137.96 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,162.28 Typical High $5,495.41 | Facility | None | $1,445.44 | $3,162.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $3,715.35 | Professional | None | $1,995.26 | $3,162.28 | $3,715.35 |
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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,238.72 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,754.23 | $2,754.23 | $3,467.37 |
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 $2,630.27 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,090.30 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $4,168.69 | Facility | None | $1,318.26 | $1,348.96 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,548.82 | $2,344.23 |
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 $1,584.89 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,187.76 | $3,235.94 |
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 $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,000.00 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $398.11 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,513.56 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $302.00 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,819.70 Median $3,311.31 Typical High $12,589.25 | Facility | 50 · Both sides | $1,819.70 | $3,311.31 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,801.89 Median $4,265.80 Typical High $4,677.35 | Professional | 50 · Both sides | $3,801.89 | $4,265.80 | $4,677.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,570.40 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,290.87 | $2,570.40 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,090.30 Median $3,467.37 Typical High $3,715.35 | Professional | 63 · Small infant | $3,090.30 | $3,467.37 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,995.26 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 80 · Assistant surgeon | $407.38 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $407.38 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $389.05 Typical High $426.58 | Professional | AS · PA/NP assist | $346.74 | $389.05 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,000.00 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $398.11 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,513.56 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $302.00 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $199.53 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,187.76 | $2,187.76 |
Where Idaho sits
The same service costs 15.8 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
$2,754
AK $6,310TX $398
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.