How much rates vary
Facilitymedian $4,786 · 10th to 90th $2,138 to $17,378Professionalmedian $2,042 · 10th to 90th $1,288 to $2,344
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 $4,677.35 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $6,456.54 Typical High $18,620.87 | Facility | None | $4,073.80 | $6,456.54 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,041.74 | $2,137.96 |
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 $1,258.93 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,445.44 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,174.90 | $2,137.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,137.96 | $2,511.89 |
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 $1,513.56 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,513.56 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
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 $1,905.46 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,137.96 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $13,182.57 | Facility | None | $891.25 | $912.01 | $13,182.57 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $4,168.69 | Professional | None | $891.25 | $1,047.13 | $4,168.69 |
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 $1,096.48 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,513.56 | $2,238.72 |
18 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 54 · Surgery only Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,000.00 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $199.53 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $134.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $933.25 | $1,479.11 | $1,479.11 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,888.44 Median $9,772.37 Typical High $28,183.83 | Facility | 50 · Both sides | $5,888.44 | $9,772.37 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,019.95 Typical High $3,235.94 | Professional | 50 · Both sides | $2,570.40 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $199.53 | $213.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,089.30 Median $2,398.83 Typical High $2,570.40 | Professional | 63 · Small infant | $2,089.30 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 80 · Assistant surgeon | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | AS · PA/NP assist | $234.42 | $269.15 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,000.00 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $199.53 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $134.90 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $933.25 | $1,479.11 | $1,479.11 |
Where Idaho sits
The same service costs 7.6 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· 8th of 51
$2,138
AK $4,266TX $562
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.