How much rates vary
Facilitymedian $2,042 · 10th to 90th $575 to $7,244Professionalmedian $501 · 10th to 90th $331 to $759
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $758.58 | Professional | None | $302.00 | $489.78 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,454.71 Typical High $8,511.38 | Facility | None | $1,621.81 | $2,454.71 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $758.58 | Professional | None | $407.38 | $537.03 | $758.58 |
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 $309.03 Median $416.87 Typical High $588.84 | Professional | None | $309.03 | $416.87 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $691.83 Typical High $5,495.41 | Facility | None | $302.00 | $691.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $758.58 | Professional | None | $363.08 | $575.44 | $758.58 |
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 $436.52 Median $436.52 Typical High $707.95 | Facility | None | $436.52 | $436.52 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $891.25 | Professional | None | $436.52 | $549.54 | $891.25 |
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 $467.74 Median $575.44 Typical High $870.96 | Professional | None | $467.74 | $575.44 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $338.84 Typical High $4,168.69 | Facility | None | $331.13 | $338.84 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $1,862.09 | Professional | None | $239.88 | $331.13 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $724.44 | Professional | None | $257.04 | $407.38 | $724.44 |
26 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 $147.91 Median $245.47 Typical High $380.19 | Professional | 52 · Reduced service | $147.91 | $245.47 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $97.72 Typical High $151.36 | Professional | 53 · Discontinued | $60.26 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $223.87 | $363.08 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $72.44 Typical High $112.20 | Professional | 55 · Aftercare only | $44.67 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $48.98 Typical High $75.86 | Professional | 56 · Pre-op care only | $30.20 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $338.84 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $208.93 | $338.84 | $524.81 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,398.83 Median $3,311.31 Typical High $12,589.25 | Facility | 50 · Both sides | $2,398.83 | $3,311.31 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $794.33 Typical High $1,122.02 | Professional | 50 · Both sides | $602.56 | $794.33 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $691.83 | Professional | 54 · Surgery only | $363.08 | $478.63 | $691.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $40.74 | $64.57 | $79.43 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $588.84 Typical High $933.25 | Professional | 63 · Small infant | $489.78 | $588.84 | $933.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $281.84 | $371.54 | $501.19 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $79.43 Typical High $120.23 | Professional | 80 · Assistant surgeon | $64.57 | $79.43 | $120.23 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $104.71 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $64.57 | $104.71 | $123.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $100.00 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $100.00 | $125.89 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $64.57 Typical High $107.15 | Professional | AS · PA/NP assist | $54.95 | $64.57 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $245.47 Typical High $380.19 | Professional | 52 · Reduced service | $147.91 | $245.47 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $97.72 Typical High $151.36 | Professional | 53 · Discontinued | $60.26 | $97.72 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $223.87 | $363.08 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $72.44 Typical High $112.20 | Professional | 55 · Aftercare only | $44.67 | $72.44 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $48.98 Typical High $75.86 | Professional | 56 · Pre-op care only | $30.20 | $48.98 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $338.84 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $208.93 | $338.84 | $524.81 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $1,230.27 | Professional | 50 · Both sides | $794.33 | $794.33 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $575.44 | Professional | 54 · Surgery only | $371.54 | $371.54 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $616.60 |
Where Idaho sits
The same service costs 5.5 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
$525
AK $1,202TX $219
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.