How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,692 to $16,218Professionalmedian $3,162 · 10th to 90th $2,089 to $3,631
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 $3,981.07 Typical High $7,762.47 | Facility | None | $2,884.03 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $3,388.44 Typical High $3,388.44 | Professional | None | $1,698.24 | $3,388.44 | $3,388.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $7,079.46 Typical High $18,620.87 | Facility | None | $4,897.79 | $7,079.46 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,388.44 | Professional | None | $2,691.53 | $3,162.28 | $3,388.44 |
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 $1,995.26 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,995.26 | $2,290.87 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $5,495.41 | Facility | None | $1,862.09 | $3,981.07 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,089.30 | $3,388.44 | $3,981.07 |
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 $2,344.23 Median $3,311.31 Typical High $3,311.31 | Facility | None | $2,344.23 | $3,311.31 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,311.31 | $3,890.45 |
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 $2,884.03 Median $3,311.31 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,311.31 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $13,182.57 | Facility | None | $1,380.38 | $1,412.54 | $13,182.57 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $4,168.69 | Professional | None | $1,380.38 | $1,659.59 | $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 $1,778.28 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,398.83 | $3,548.13 |
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 $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,584.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $316.23 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $208.93 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,344.23 | $2,344.23 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $10,715.19 Typical High $28,183.83 | Facility | 50 · Both sides | $7,413.10 | $10,715.19 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $4,570.88 Typical High $5,011.87 | Professional | 50 · Both sides | $3,981.07 | $4,570.88 | $5,011.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,754.23 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,398.83 | $2,754.23 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,235.94 Median $3,715.35 Typical High $4,073.80 | Professional | 63 · Small infant | $3,235.94 | $3,715.35 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,137.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,137.96 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | 80 · Assistant surgeon | $426.58 | $489.78 | $537.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $426.58 | $489.78 | $537.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $426.58 | $489.78 | $537.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $416.87 Typical High $457.09 | Professional | AS · PA/NP assist | $363.08 | $416.87 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,584.89 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $316.23 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $208.93 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,344.23 | $2,344.23 |
Where Idaho sits
The same service costs 7.8 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
$3,236
AK $6,761TX $871
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.