How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,259 to $29,512Professionalmedian $1,122 · 10th to 90th $776 to $1,380
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | None | $794.33 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,090.30 Median $12,022.64 Typical High $34,673.69 | Facility | None | $3,090.30 | $12,022.64 | $34,673.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,230.27 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $10,471.29 Median $11,748.98 Typical High $15,848.93 | Facility | None | $10,471.29 | $11,748.98 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $977.24 | Professional | None | $724.44 | $851.14 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,778.28 Typical High $8,709.64 | Facility | None | $741.31 | $1,778.28 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,479.11 | Professional | None | $794.33 | $1,258.93 | $1,479.11 |
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 $912.01 Median $1,122.02 Typical High $1,122.02 | Facility | None | $912.01 | $1,122.02 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $23,988.33 Median $33,884.42 Typical High $42,657.95 | Facility | None | $23,988.33 | $33,884.42 | $42,657.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,258.93 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $10,964.78 | Facility | None | $537.03 | $549.54 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $10,715.19 | Professional | None | $537.03 | $630.96 | $10,715.19 |
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 $660.69 Median $891.25 Typical High $1,318.26 | Professional | None | $660.69 | $891.25 | $1,318.26 |
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 $389.05 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $389.05 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $158.49 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $79.43 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $870.96 | $870.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,365.16 Median $17,782.79 Typical High $54,954.09 | Facility | 50 · Both sides | $4,365.16 | $17,782.79 | $54,954.09 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,737.80 Typical High $1,905.46 | Professional | 50 · Both sides | $1,548.82 | $1,737.80 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $125.89 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | 62 · Two surgeons | $645.65 | $724.44 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 63 · Small infant | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 80 · Assistant surgeon | $165.96 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $165.96 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $158.49 Typical High $169.82 | Professional | AS · PA/NP assist | $141.25 | $158.49 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $389.05 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $158.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $588.84 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $79.43 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $870.96 | $870.96 |
Where Idaho sits
The same service costs 10.1 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $19,890MT $1,977
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.