How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,585 to $17,378Professionalmedian $1,514 · 10th to 90th $955 to $1,778
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 $794.33 Median $1,584.89 Typical High $1,584.89 | Professional | None | $794.33 | $1,584.89 | $1,584.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,981.07 Median $6,606.93 Typical High $18,620.87 | Facility | None | $3,981.07 | $6,606.93 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,513.56 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,230.27 | Professional | None | $933.25 | $1,071.52 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,584.89 Typical High $8,709.64 | Facility | None | $891.25 | $1,584.89 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,584.89 | $1,862.09 |
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 $1,148.15 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,148.15 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
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 $1,412.54 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,584.89 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $10,715.19 | Facility | None | $660.69 | $676.08 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $5,754.40 | Professional | None | $660.69 | $776.25 | $5,754.40 |
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 $831.76 Median $1,122.02 Typical High $1,659.59 | Professional | None | $831.76 | $1,122.02 | $1,659.59 |
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 $501.19 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $501.19 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $758.58 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $151.36 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $100.00 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $707.95 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $10,000.00 Typical High $28,183.83 | Facility | 50 · Both sides | $6,025.60 | $10,000.00 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,238.72 Typical High $2,398.83 | Professional | 50 · Both sides | $1,949.84 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $933.25 Typical High $1,000.00 | Professional | 62 · Two surgeons | $812.83 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 63 · Small infant | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 80 · Assistant surgeon | $208.93 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $208.93 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $213.80 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $501.19 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $758.58 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $151.36 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $100.00 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $707.95 | $1,122.02 | $1,122.02 |
Where Idaho sits
The same service costs 5.9 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $14,644MT $2,489
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.