How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,622 to $18,621Professionalmedian $1,778 · 10th to 90th $1,175 to $2,042
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 $1,174.90 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,862.09 | $1,862.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $7,244.36 Typical High $18,620.87 | Facility | None | $3,467.37 | $7,244.36 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,778.28 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $5,495.41 | Facility | None | $933.25 | $1,862.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,862.09 | $2,187.76 |
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 $1,348.96 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,348.96 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,621.81 | $2,089.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,862.09 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $8,709.64 | Facility | None | $776.25 | $794.33 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $6,165.95 | Professional | None | $776.25 | $912.01 | $6,165.95 |
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 $954.99 Median $1,318.26 Typical High $1,949.84 | Professional | None | $954.99 | $1,318.26 | $1,949.84 |
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 $588.84 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $588.84 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $234.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $870.96 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $173.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $117.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $812.83 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,466.84 Median $10,964.78 Typical High $28,183.83 | Facility | 50 · Both sides | $4,466.84 | $10,964.78 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,511.89 Typical High $2,754.23 | Professional | 50 · Both sides | $2,290.87 | $2,511.89 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $181.97 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,819.70 Median $2,041.74 Typical High $2,187.76 | Professional | 63 · Small infant | $1,819.70 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 80 · Assistant surgeon | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $269.15 | $295.12 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $251.19 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $588.84 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $234.42 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $870.96 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $173.78 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $117.49 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $812.83 | $1,288.25 | $1,288.25 |
Where Idaho sits
The same service costs 17.4 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· 8th of 51
$1,820
AK $3,715TX $214
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.