How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,138 to $10,965Professionalmedian $2,188 · 10th to 90th $1,514 to $2,692
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 $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,548.82 | $2,454.71 | $2,454.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,365.16 Median $6,025.60 Typical High $12,022.64 | Facility | None | $4,365.16 | $6,025.60 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,344.23 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $5,248.07 | $5,888.44 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,659.59 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,454.71 Typical High $5,495.41 | Facility | None | $1,288.25 | $2,454.71 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,454.71 | $2,884.03 |
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 $1,737.80 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,737.80 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
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 $2,089.30 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,454.71 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Facility | None | $1,023.29 | $1,023.29 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $5,370.32 | Professional | None | $1,023.29 | $1,202.26 | $5,370.32 |
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 $1,288.25 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,288.25 | $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 $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $776.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $309.03 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,148.15 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $234.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,606.93 Median $9,332.54 Typical High $18,197.01 | Facility | 50 · Both sides | $6,606.93 | $9,332.54 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,311.31 Typical High $3,630.78 | Professional | 50 · Both sides | $2,951.21 | $3,311.31 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,778.28 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,398.83 Median $2,691.53 Typical High $2,884.03 | Professional | 63 · Small infant | $2,398.83 | $2,691.53 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 80 · Assistant surgeon | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $302.00 Typical High $331.13 | Professional | AS · PA/NP assist | $269.15 | $302.00 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $776.25 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $309.03 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,148.15 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $234.42 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $154.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,737.80 | $1,737.80 |
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· 11th of 51
$2,239
AK $5,012TX $575
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.