How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,698 to $16,218Professionalmedian $1,738 · 10th to 90th $1,202 to $2,138
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 $5,011.87 Typical High $8,709.64 | Facility | None | $3,388.44 | $5,011.87 | $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 $4,786.30 Median $6,606.93 Typical High $18,620.87 | Facility | None | $4,786.30 | $6,606.93 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,862.09 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,348.96 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $5,495.41 | Facility | None | $1,047.13 | $2,089.30 | $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 $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 $1,737.80 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,949.84 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $13,489.63 | Facility | None | $812.83 | $831.76 | $13,489.63 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $4,168.69 | Professional | None | $812.83 | $977.24 | $4,168.69 |
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 $1,023.29 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,412.54 | $2,089.30 |
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 $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $186.21 | $295.12 | $295.12 |
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 $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $870.96 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,918.31 Median $9,772.37 Typical High $28,183.83 | Facility | 50 · Both sides | $6,918.31 | $9,772.37 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,630.27 Typical High $2,884.03 | Professional | 50 · Both sides | $2,398.83 | $2,630.27 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $190.55 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,096.48 Typical High $1,202.26 | Professional | 62 · Two surgeons | $1,000.00 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,905.46 Median $2,137.96 Typical High $2,290.87 | Professional | 63 · Small infant | $1,905.46 | $2,137.96 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 80 · Assistant surgeon | $251.19 | $281.84 | $309.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $251.19 | $281.84 | $309.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $281.84 | $309.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $239.88 Typical High $263.03 | Professional | AS · PA/NP assist | $213.80 | $239.88 | $263.03 |
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 $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $933.25 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $186.21 | $295.12 | $295.12 |
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 $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $870.96 | $1,380.38 | $1,380.38 |
Where Idaho sits
The same service costs 7.9 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
$1,820
AK $3,981TX $501
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.