How much rates vary
Facilitymedian $11,482 · 10th to 90th $2,239 to $29,512Professionalmedian $2,291 · 10th to 90th $1,549 to $2,754
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 $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,621.81 | $2,570.40 | $2,570.40 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $13,182.57 Typical High $34,673.69 | Facility | None | $5,888.44 | $13,182.57 | $34,673.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,454.71 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $10,471.29 Median $11,748.98 Typical High $16,218.10 | Facility | None | $10,471.29 | $11,748.98 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,737.80 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $5,495.41 | Facility | None | $1,288.25 | $2,570.40 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,570.40 | $3,019.95 |
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 $1,819.70 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,819.70 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,238.72 | $2,818.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $23,988.33 Median $33,884.42 Typical High $42,657.95 | Facility | None | $23,988.33 | $33,884.42 | $42,657.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,019.95 | Professional | None | $2,290.87 | $2,570.40 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $20,417.38 | Facility | None | $1,071.52 | $1,096.48 | $20,417.38 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $10,964.78 | Professional | None | $1,071.52 | $1,258.93 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,819.70 | $2,691.53 |
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 $794.33 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $794.33 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $323.59 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,202.26 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $239.88 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $162.18 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $8,912.51 Median $19,952.62 Typical High $54,954.09 | Facility | 50 · Both sides | $8,912.51 | $19,952.62 | $54,954.09 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,467.37 Typical High $3,801.89 | Professional | 50 · Both sides | $3,090.30 | $3,467.37 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,089.30 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,862.09 | $2,089.30 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $251.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,445.44 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,288.25 | $1,445.44 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $2,754.23 Typical High $3,019.95 | Professional | 63 · Small infant | $2,511.89 | $2,754.23 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,621.81 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | 80 · Assistant surgeon | $331.13 | $371.54 | $398.11 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $331.13 | $371.54 | $398.11 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $371.54 | $398.11 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $316.23 Typical High $338.84 | Professional | AS · PA/NP assist | $281.84 | $316.23 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $794.33 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $323.59 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,202.26 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $239.88 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $162.18 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,778.28 | $1,778.28 |
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· 8th of 51
$2,399
AK $5,129TX $676
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.