How much rates vary
Facilitymedian $10,471 · 10th to 90th $2,291 to $29,512Professionalmedian $2,344 · 10th to 90th $1,622 to $2,818
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 $1,659.59 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,659.59 | $2,630.27 | $2,630.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $13,182.57 Typical High $34,673.69 | Facility | None | $3,388.44 | $13,182.57 | $34,673.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,511.89 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $9,772.37 Median $10,964.78 Typical High $14,791.08 | Facility | None | $9,772.37 | $10,964.78 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,778.28 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,630.27 Typical High $5,495.41 | Facility | None | $1,348.96 | $2,630.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,630.27 | $3,090.30 |
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 $1,862.09 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,862.09 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,884.03 | Professional | None | $2,290.87 | $2,290.87 | $2,884.03 |
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 $2,344.23 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,344.23 | $2,630.27 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $15,848.93 | Facility | None | $1,096.48 | $1,122.02 | $15,848.93 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $10,000.00 | Professional | None | $1,096.48 | $1,288.25 | $10,000.00 |
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 $1,318.26 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,862.09 | $2,691.53 |
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 $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $831.76 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $331.13 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,258.93 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $251.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,862.09 | $1,862.09 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,265.80 Median $19,498.45 Typical High $54,954.09 | Facility | 50 · Both sides | $4,265.80 | $19,498.45 | $54,954.09 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,235.94 Median $3,548.13 Typical High $3,890.45 | Professional | 50 · Both sides | $3,235.94 | $3,548.13 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,137.96 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $2,137.96 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,479.11 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,348.96 | $1,479.11 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,570.40 Median $2,884.03 Typical High $3,090.30 | Professional | 63 · Small infant | $2,570.40 | $2,884.03 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 80 · Assistant surgeon | $338.84 | $380.19 | $416.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $338.84 | $380.19 | $416.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $380.19 | $416.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | AS · PA/NP assist | $288.40 | $323.59 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $831.76 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $331.13 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,258.93 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $251.19 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $165.96 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,862.09 | $1,862.09 |
Where Idaho sits
The same service costs 7.4 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
$2,455
AK $5,248TX $708
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.