How much rates vary
Facilitymedian $1,820 · 10th to 90th $977 to $4,898Professionalmedian $1,202 · 10th to 90th $759 to $1,445
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 $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | None | $676.08 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $4,786.30 | Facility | None | $1,174.90 | $2,570.40 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,230.27 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $977.24 | Professional | None | $707.95 | $851.14 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $5,495.41 | Facility | None | $602.56 | $1,258.93 | $5,495.41 |
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 $933.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $933.25 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,288.25 | $1,479.11 |
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 $1,071.52 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,258.93 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $4,786.30 | Facility | None | $537.03 | $549.54 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $977.24 | Professional | None | $537.03 | $630.96 | $977.24 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,412.54 | $1,819.70 | $3,235.94 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,258.93 | Professional | None | $602.56 | $870.96 | $1,258.93 |
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 $398.11 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $398.11 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $162.18 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $602.56 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $120.23 | $190.55 | $190.55 |
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 $562.34 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $562.34 | $891.25 | $891.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $3,801.89 Typical High $7,244.36 | Facility | 50 · Both sides | $1,778.28 | $3,801.89 | $7,244.36 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,819.70 Typical High $1,905.46 | Professional | 50 · Both sides | $1,584.89 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $128.82 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $758.58 Typical High $794.33 | Professional | 62 · Two surgeons | $660.69 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 63 · Small infant | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 80 · Assistant surgeon | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $398.11 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $162.18 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $602.56 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $120.23 | $190.55 | $190.55 |
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 $562.34 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $562.34 | $891.25 | $891.25 |
Where Idaho sits
The same service costs 7.2 times more in Alaska than in Utah. 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· 7th of 51
$1,230
AK $2,570UT $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.