How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,514 to $7,762Professionalmedian $1,820 · 10th to 90th $1,259 to $2,239
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 $1,071.52 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,071.52 | $2,089.30 | $2,089.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,890.45 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,949.84 | $2,041.74 |
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 $1,230.27 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,445.44 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,089.30 Typical High $5,495.41 | Facility | None | $933.25 | $2,089.30 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,258.93 | $2,089.30 | $2,454.71 |
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 $1,479.11 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,479.11 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
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 $1,698.24 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,995.26 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $5,248.07 | Facility | None | $870.96 | $870.96 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,862.09 | Professional | None | $870.96 | $1,023.29 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,513.56 | $2,187.76 |
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 $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $616.60 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $251.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $933.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $186.21 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $125.89 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $870.96 | $1,479.11 | $1,479.11 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $5,888.44 Typical High $12,589.25 | Facility | 50 · Both sides | $3,311.31 | $5,888.44 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,818.38 Typical High $3,019.95 | Professional | 50 · Both sides | $2,511.89 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,698.24 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,513.56 | $1,698.24 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $204.17 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,995.26 Median $2,238.72 Typical High $2,454.71 | Professional | 63 · Small infant | $1,995.26 | $2,238.72 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $302.00 Typical High $323.59 | Professional | 80 · Assistant surgeon | $269.15 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $302.00 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $269.15 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $302.00 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | AS · PA/NP assist | $229.09 | $251.19 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $616.60 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $251.19 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $933.25 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $186.21 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $125.89 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $870.96 | $1,479.11 | $1,479.11 |
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· 10th of 51
$1,862
AK $3,981TX $525
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.