How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,698 to $10,233Professionalmedian $2,089 · 10th to 90th $1,479 to $2,570
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 $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,513.56 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,265.80 Median $6,165.95 Typical High $12,022.64 | Facility | None | $4,265.80 | $6,165.95 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,905.46 | $2,238.72 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,659.59 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,398.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,398.83 | $2,818.38 |
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 $1,659.59 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,659.59 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,398.83 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Facility | None | $977.24 | $977.24 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $5,248.07 | Professional | None | $977.24 | $1,174.90 | $5,248.07 |
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 $1,318.26 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,737.80 | $2,570.40 |
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 $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $758.58 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $302.00 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,122.02 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $223.87 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $151.36 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,698.24 | $1,698.24 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,677.35 Median $9,332.54 Typical High $18,197.01 | Facility | 50 · Both sides | $4,677.35 | $9,332.54 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,162.28 Typical High $3,467.37 | Professional | 50 · Both sides | $2,818.38 | $3,162.28 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,905.46 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $229.09 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,318.26 Typical High $1,445.44 | Professional | 62 · Two surgeons | $1,174.90 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,238.72 Median $2,570.40 Typical High $2,754.23 | Professional | 63 · Small infant | $2,238.72 | $2,570.40 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | AS · PA/NP assist | $257.04 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $758.58 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $302.00 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,122.02 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $223.87 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $151.36 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,698.24 | $1,698.24 |
Where Idaho sits
The same service costs 8.7 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
$2,138
AK $4,786TX $550
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.