How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,230 to $7,762Professionalmedian $1,148 · 10th to 90th $501 to $2,818
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 $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,202.26 Typical High $3,890.45 | Professional | None | $398.11 | $1,202.26 | $3,890.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $8,317.64 | Facility | None | $1,949.84 | $3,388.44 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $2,187.76 Typical High $2,818.38 | Professional | None | $630.96 | $2,187.76 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,778.28 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $2,187.76 | Professional | None | $501.19 | $812.83 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,621.81 Typical High $5,495.41 | Facility | None | $489.78 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $1,202.26 Typical High $3,890.45 | Professional | None | $602.56 | $1,202.26 | $3,890.45 |
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 $691.83 Median $691.83 Typical High $2,570.40 | Facility | None | $691.83 | $691.83 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $691.83 Median $2,454.71 Typical High $2,570.40 | Professional | None | $691.83 | $2,454.71 | $2,570.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $10,471.29 | Facility | None | $5,495.41 | $7,943.28 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $2,454.71 | Professional | None | $707.95 | $812.83 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $5,888.44 | Facility | None | $1,230.27 | $1,258.93 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $1,230.27 Typical High $1,479.11 | Professional | None | $446.68 | $1,230.27 | $1,479.11 |
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 $416.87 Median $1,071.52 Typical High $2,511.89 | Professional | None | $416.87 | $1,071.52 | $2,511.89 |
22 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 $245.47 Median $575.44 Typical High $1,949.84 | Professional | 52 · Reduced service | $245.47 | $575.44 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $229.09 Typical High $776.25 | Professional | 53 · Discontinued | $97.72 | $229.09 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $851.14 Typical High $2,884.03 | Professional | 54 · Surgery only | $371.54 | $851.14 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $169.82 Typical High $575.44 | Professional | 55 · Aftercare only | $74.13 | $169.82 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $114.82 Typical High $389.05 | Professional | 56 · Pre-op care only | $48.98 | $114.82 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $794.33 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $346.74 | $794.33 | $2,691.53 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $5,128.61 Typical High $12,589.25 | Facility | 50 · Both sides | $2,951.21 | $5,128.61 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,148.15 Typical High $4,365.16 | Professional | 50 · Both sides | $954.99 | $1,148.15 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $2,454.71 | Professional | 54 · Surgery only | $575.44 | $691.83 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $77.62 Typical High $245.47 | Professional | 55 · Aftercare only | $63.10 | $77.62 | $245.47 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $758.58 Median $933.25 Typical High $3,388.44 | Professional | 63 · Small infant | $758.58 | $933.25 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $123.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $102.33 | $123.03 | $467.74 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $123.03 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $97.72 | $123.03 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $123.03 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $123.03 | $426.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $104.71 Typical High $380.19 | Professional | AS · PA/NP assist | $87.10 | $104.71 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $575.44 Typical High $1,949.84 | Professional | 52 · Reduced service | $251.19 | $575.44 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $229.09 Typical High $776.25 | Professional | 53 · Discontinued | $100.00 | $229.09 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $851.14 Typical High $2,884.03 | Professional | 54 · Surgery only | $380.19 | $851.14 | $2,884.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $169.82 Typical High $575.44 | Professional | 55 · Aftercare only | $75.86 | $169.82 | $575.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $114.82 Typical High $389.05 | Professional | 56 · Pre-op care only | $50.12 | $114.82 | $389.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $794.33 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $354.81 | $794.33 | $2,691.53 |
Where Idaho sits
The same service costs 4.4 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· 8th of 51
$1,862
AK $3,020NE $692
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.