How much rates vary
Facilitymedian $4,467 · 10th to 90th $759 to $16,218Professionalmedian $741 · 10th to 90th $490 to $871
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $776.25 | Professional | None | $501.19 | $776.25 | $776.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,905.46 Median $4,897.79 Typical High $18,620.87 | Facility | None | $1,905.46 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $831.76 | Professional | None | $691.83 | $794.33 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $602.56 | Professional | None | $436.52 | $524.81 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $776.25 Typical High $5,495.41 | Facility | None | $501.19 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $933.25 | Professional | None | $501.19 | $776.25 | $933.25 |
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 $602.56 Median $741.31 Typical High $741.31 | Facility | None | $602.56 | $741.31 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | None | $741.31 | $741.31 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $933.25 | Professional | None | $724.44 | $794.33 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $4,786.30 | Facility | None | $354.81 | $363.08 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $4,168.69 | Professional | None | $354.81 | $398.11 | $4,168.69 |
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 $407.38 Median $562.34 Typical High $831.76 | Professional | None | $407.38 | $562.34 | $831.76 |
22 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 $251.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $251.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $380.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $50.12 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $354.81 | $549.54 | $549.54 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $2,754.23 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,148.15 Typical High $1,258.93 | Professional | 50 · Both sides | $1,023.29 | $1,148.15 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $691.83 | $741.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $83.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $812.83 Median $912.01 Typical High $1,000.00 | Professional | 63 · Small infant | $812.83 | $912.01 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $575.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $123.03 Typical High $131.83 | Professional | 80 · Assistant surgeon | $109.65 | $123.03 | $131.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $123.03 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $109.65 | $123.03 | $131.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $123.03 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $123.03 | $131.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $104.71 Typical High $112.20 | Professional | AS · PA/NP assist | $93.33 | $104.71 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $251.19 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $100.00 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $380.19 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $50.12 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $354.81 | $549.54 | $549.54 |
Where Idaho sits
The same service costs 7.2 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· 9th of 51
$776
AK $1,622TX $224
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.