How much rates vary
Facilitymedian $295 · 10th to 90th $158 to $708Professionalmedian $407 · 10th to 90th $257 to $525
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 $257.04 Median $398.11 Typical High $478.63 | Professional | None | $257.04 | $398.11 | $478.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $263.03 Typical High $616.60 | Facility | None | $177.83 | $263.03 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $562.34 | Professional | None | $363.08 | $446.68 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $363.08 | Professional | None | $239.88 | $302.00 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $478.63 Typical High $5,495.41 | Facility | None | $199.53 | $478.63 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $512.86 | Professional | None | $316.23 | $436.52 | $512.86 |
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 $389.05 Median $389.05 Typical High $512.86 | Facility | None | $389.05 | $389.05 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $645.65 | Professional | None | $389.05 | $501.19 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $575.44 | Professional | None | $407.38 | $478.63 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $457.09 | Facility | None | $245.47 | $251.19 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $316.23 | Professional | None | $151.36 | $245.47 | $316.23 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $389.05 | Professional | None | $169.82 | $275.42 | $389.05 |
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 $128.82 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $128.82 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $51.29 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $25.70 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $281.84 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $181.97 | $281.84 | $331.13 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $251.19 Median $389.05 Typical High $912.01 | Facility | 50 · Both sides | $251.19 | $389.05 | $912.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $660.69 Typical High $831.76 | Professional | 50 · Both sides | $549.54 | $660.69 | $831.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $389.05 Typical High $501.19 | Professional | 54 · Surgery only | $323.59 | $389.05 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $36.31 | $44.67 | $56.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $436.52 Median $537.03 Typical High $676.08 | Professional | 63 · Small infant | $436.52 | $537.03 | $676.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $389.05 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $69.18 Typical High $87.10 | Professional | 80 · Assistant surgeon | $57.54 | $69.18 | $87.10 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $70.79 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $57.54 | $70.79 | $89.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $72.44 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $72.44 | $89.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $60.26 Typical High $75.86 | Professional | AS · PA/NP assist | $48.98 | $60.26 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $128.82 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $51.29 | $79.43 | $95.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $302.00 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $60.26 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $25.70 | $39.81 | $47.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $281.84 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $181.97 | $281.84 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | 50 · Both sides | $676.08 | $676.08 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $316.23 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $398.11 |
Where Idaho sits
The same service costs 5.0 times more in Alaska than in Florida. 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
$398
AK $832FL $166
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.