How much rates vary
Facilitymedian $2,042 · 10th to 90th $407 to $7,244Professionalmedian $776 · 10th to 90th $501 to $912
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | None | $537.03 | $831.76 | $831.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,148.15 Median $2,187.76 Typical High $8,511.38 | Facility | None | $1,148.15 | $2,187.76 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | None | $707.95 | $831.76 | $870.96 |
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 $457.09 Median $562.34 Typical High $630.96 | Professional | None | $457.09 | $562.34 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $5,495.41 | Facility | None | $407.38 | $831.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,000.00 | Professional | None | $537.03 | $831.76 | $1,000.00 |
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 $630.96 Median $776.25 Typical High $776.25 | Facility | None | $630.96 | $776.25 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $977.24 | Professional | None | $776.25 | $776.25 | $977.24 |
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 $758.58 Median $851.14 Typical High $1,000.00 | Professional | None | $758.58 | $851.14 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $3,162.28 | Facility | None | $371.54 | $371.54 | $3,162.28 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $1,862.09 | Professional | None | $371.54 | $416.87 | $1,862.09 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $851.14 | Professional | None | $416.87 | $575.44 | $851.14 |
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 $269.15 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $107.15 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $398.11 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $79.43 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $53.70 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $371.54 | $588.84 | $588.84 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,548.82 Median $3,311.31 Typical High $12,589.25 | Facility | 50 · Both sides | $1,548.82 | $3,311.31 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,202.26 Typical High $1,288.25 | Professional | 50 · Both sides | $1,071.52 | $1,202.26 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $87.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $954.99 Typical High $1,047.13 | Professional | 63 · Small infant | $851.14 | $954.99 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 80 · Assistant surgeon | $114.82 | $128.82 | $138.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $114.82 | $128.82 | $138.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $128.82 | $138.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | AS · PA/NP assist | $97.72 | $107.15 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $107.15 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $398.11 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $79.43 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $53.70 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $371.54 | $588.84 | $588.84 |
Where Idaho sits
The same service costs 8.1 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
$794
AK $1,698TX $209
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.