How much rates vary
Facilitymedian $1,096 · 10th to 90th $437 to $4,467Professionalmedian $389 · 10th to 90th $219 to $661
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $758.58 | Professional | None | $213.80 | $389.05 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $4,466.84 | Facility | None | $1,096.48 | $2,511.89 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $660.69 | Professional | None | $251.19 | $457.09 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,412.54 | Facility | None | $933.25 | $1,047.13 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $478.63 | Professional | None | $218.78 | $338.84 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $446.68 Typical High $5,495.41 | Facility | None | $199.53 | $446.68 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $758.58 | Professional | None | $229.09 | $389.05 | $758.58 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $602.56 | Facility | None | $269.15 | $269.15 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $602.56 | Professional | None | $269.15 | $309.03 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $5,495.41 | Facility | None | $2,884.03 | $4,168.69 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $630.96 | Professional | None | $309.03 | $338.84 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $3,981.07 | Facility | None | $288.40 | $295.12 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $389.05 | Professional | None | $169.82 | $288.40 | $389.05 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $575.44 | Professional | None | $173.78 | $323.59 | $575.44 |
20 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 $107.15 Median $194.98 Typical High $380.19 | Professional | 52 · Reduced service | $107.15 | $194.98 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $77.62 Typical High $151.36 | Professional | 53 · Discontinued | $42.66 | $77.62 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $288.40 Typical High $575.44 | Professional | 54 · Surgery only | $158.49 | $288.40 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $31.62 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $38.90 Typical High $75.86 | Professional | 56 · Pre-op care only | $21.38 | $38.90 | $75.86 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,659.59 Median $3,235.94 Typical High $6,760.83 | Facility | 50 · Both sides | $1,659.59 | $3,235.94 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $446.68 Typical High $933.25 | Professional | 50 · Both sides | $389.05 | $446.68 | $933.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $223.87 | $489.78 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $66.07 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $295.12 Median $363.08 Typical High $741.31 | Professional | 63 · Small infant | $295.12 | $363.08 | $741.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $323.59 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $173.78 | $323.59 | $457.09 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $46.77 Typical High $104.71 | Professional | 80 · Assistant surgeon | $39.81 | $46.77 | $104.71 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $46.77 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $39.81 | $46.77 | $107.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $47.86 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $47.86 | $93.33 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $39.81 Typical High $89.13 | Professional | AS · PA/NP assist | $33.11 | $39.81 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $194.98 Typical High $380.19 | Professional | 52 · Reduced service | $107.15 | $194.98 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $77.62 Typical High $151.36 | Professional | 53 · Discontinued | $42.66 | $77.62 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $288.40 Typical High $575.44 | Professional | 54 · Surgery only | $158.49 | $288.40 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $31.62 | $57.54 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $38.90 Typical High $75.86 | Professional | 56 · Pre-op care only | $21.38 | $38.90 | $75.86 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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
$457
AK $933KY $240
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.