How much rates vary
Facilitymedian $1,585 · 10th to 90th $759 to $4,467Professionalmedian $794 · 10th to 90th $479 to $1,259
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 $457.09 Median $707.95 Typical High $1,202.26 | Professional | None | $457.09 | $707.95 | $1,202.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $4,365.16 | Facility | None | $1,584.89 | $2,511.89 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,348.96 | Professional | None | $630.96 | $933.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,949.84 | Facility | None | $1,288.25 | $1,445.44 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $933.25 | Professional | None | $457.09 | $588.84 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $812.83 Typical High $5,495.41 | Facility | None | $371.54 | $812.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,288.25 | Professional | None | $588.84 | $851.14 | $1,288.25 |
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 $691.83 Median $691.83 Typical High $1,230.27 | Facility | None | $691.83 | $691.83 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,548.82 | Professional | None | $691.83 | $870.96 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,412.54 | Professional | None | $724.44 | $851.14 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $4,365.16 | Facility | None | $588.84 | $602.56 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $1,318.26 | Professional | None | $363.08 | $588.84 | $1,318.26 |
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 $371.54 Median $630.96 Typical High $1,122.02 | Professional | None | $371.54 | $630.96 | $1,122.02 |
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 $229.09 Median $354.81 Typical High $602.56 | Professional | 52 · Reduced service | $229.09 | $354.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $141.25 Typical High $239.88 | Professional | 53 · Discontinued | $93.33 | $141.25 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $891.25 | Professional | 54 · Surgery only | $346.74 | $537.03 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $107.15 Typical High $177.83 | Professional | 55 · Aftercare only | $69.18 | $107.15 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $70.79 Typical High $120.23 | Professional | 56 · Pre-op care only | $45.71 | $70.79 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $831.76 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,467.37 Typical High $7,244.36 | Facility | 50 · Both sides | $2,344.23 | $3,467.37 | $7,244.36 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,122.02 Typical High $1,949.84 | Professional | 50 · Both sides | $954.99 | $1,122.02 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $954.99 Typical High $1,174.90 | Professional | 54 · Surgery only | $660.69 | $954.99 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $74.13 Typical High $128.82 | Professional | 55 · Aftercare only | $63.10 | $74.13 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $1,348.96 Typical High $1,584.89 | Professional | 63 · Small infant | $776.25 | $1,348.96 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $912.01 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $173.78 Typical High $213.80 | Professional | 80 · Assistant surgeon | $104.71 | $173.78 | $213.80 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $173.78 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $102.33 | $173.78 | $213.80 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $123.03 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $123.03 | $213.80 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $104.71 Typical High $181.97 | Professional | AS · PA/NP assist | $87.10 | $104.71 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $354.81 Typical High $602.56 | Professional | 52 · Reduced service | $229.09 | $354.81 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $141.25 Typical High $239.88 | Professional | 53 · Discontinued | $93.33 | $141.25 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $891.25 | Professional | 54 · Surgery only | $346.74 | $537.03 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $107.15 Typical High $177.83 | Professional | 55 · Aftercare only | $69.18 | $107.15 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $70.79 Typical High $120.23 | Professional | 56 · Pre-op care only | $45.71 | $70.79 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,174.90 Typical High $1,949.84 | Professional | 50 · Both sides | $1,174.90 | $1,174.90 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $912.01 | Professional | 54 · Surgery only | $549.54 | $549.54 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $128.82 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $977.24 |
Where Idaho sits
The same service costs 4.7 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· 10th of 51
$813
AK $1,660TX $355
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.