How much rates vary
Facilitymedian $3,236 · 10th to 90th $933 to $16,218Professionalmedian $813 · 10th to 90th $339 to $6,607
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 $281.84 Median $3,467.37 Typical High $7,762.47 | Professional | None | $281.84 | $3,467.37 | $7,762.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,570.40 Median $4,365.16 Typical High $20,892.96 | Facility | None | $2,570.40 | $4,365.16 | $20,892.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $389.05 Median $4,365.16 Typical High $6,165.95 | Professional | None | $389.05 | $4,365.16 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $4,073.80 | Facility | None | $2,691.53 | $3,019.95 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $5,495.41 | Professional | None | $354.81 | $537.03 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $3,388.44 Typical High $8,709.64 | Facility | None | $338.84 | $3,388.44 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $3,311.31 Typical High $7,762.47 | Professional | None | $338.84 | $3,311.31 | $7,762.47 |
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 $416.87 Median $416.87 Typical High $5,754.40 | Facility | None | $416.87 | $416.87 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $416.87 Median $1,148.15 Typical High $5,754.40 | Professional | None | $416.87 | $1,148.15 | $5,754.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,220.18 Median $16,218.10 Typical High $22,387.21 | Facility | None | $11,220.18 | $16,218.10 | $22,387.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $6,165.95 | Professional | None | $489.78 | $549.54 | $6,165.95 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $2,754.23 Typical High $2,754.23 | Facility | None | $741.31 | $2,754.23 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $2,754.23 Typical High $3,715.35 | Professional | None | $263.03 | $2,754.23 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $281.84 Median $2,951.21 Typical High $6,309.57 | Professional | None | $281.84 | $2,951.21 | $6,309.57 |
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 $169.82 Median $309.03 Typical High $3,890.45 | Professional | 52 · Reduced service | $169.82 | $309.03 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $125.89 Typical High $1,548.82 | Professional | 53 · Discontinued | $67.61 | $125.89 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $467.74 Typical High $5,888.44 | Professional | 54 · Surgery only | $257.04 | $467.74 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $93.33 Typical High $1,174.90 | Professional | 55 · Aftercare only | $51.29 | $93.33 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $61.66 Typical High $776.25 | Professional | 56 · Pre-op care only | $33.88 | $61.66 | $776.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $6,456.54 Median $6,456.54 Typical High $30,902.95 | Facility | 50 · Both sides | $6,456.54 | $6,456.54 | $30,902.95 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $707.95 Typical High $9,549.93 | Professional | 50 · Both sides | $588.84 | $707.95 | $9,549.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $5,623.41 | Professional | 54 · Surgery only | $338.84 | $426.58 | $5,623.41 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $645.65 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $645.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $467.74 Median $5,248.07 Typical High $7,762.47 | Professional | 63 · Small infant | $467.74 | $5,248.07 | $7,762.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $75.86 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $64.57 | $75.86 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $75.86 Typical High $1,023.29 | Professional | 81 · Minimal assistant surgeon | $61.66 | $75.86 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $75.86 Typical High $1,023.29 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $75.86 | $1,023.29 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $64.57 Typical High $870.96 | Professional | AS · PA/NP assist | $52.48 | $64.57 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $309.03 Typical High $3,890.45 | Professional | 52 · Reduced service | $169.82 | $309.03 | $3,890.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $125.89 Typical High $1,548.82 | Professional | 53 · Discontinued | $67.61 | $125.89 | $1,548.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $467.74 Typical High $5,888.44 | Professional | 54 · Surgery only | $257.04 | $467.74 | $5,888.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $93.33 Typical High $1,174.90 | Professional | 55 · Aftercare only | $51.29 | $93.33 | $1,174.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $61.66 Typical High $776.25 | Professional | 56 · Pre-op care only | $33.88 | $61.66 | $776.25 |
Where Idaho sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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· 26th of 51
$3,020
AK $5,012NE $490
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.