How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,259 to $7,762Professionalmedian $1,230 · 10th to 90th $437 to $3,311
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 $426.58 Median $1,258.93 Typical High $4,570.88 | Professional | None | $426.58 | $1,258.93 | $4,570.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $8,317.64 | Facility | None | $1,513.56 | $2,754.23 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $2,630.27 Typical High $3,311.31 | Professional | None | $549.54 | $2,630.27 | $3,311.31 |
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 $436.52 Median $707.95 Typical High $2,454.71 | Professional | None | $436.52 | $707.95 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,905.46 Typical High $6,606.93 | Facility | None | $426.58 | $1,905.46 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $2,238.72 Typical High $4,570.88 | Professional | None | $524.81 | $2,238.72 | $4,570.88 |
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 $602.56 Median $602.56 Typical High $3,019.95 | Facility | None | $602.56 | $602.56 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $2,884.03 Typical High $3,090.30 | Professional | None | $602.56 | $2,884.03 | $3,090.30 |
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 $616.60 Median $707.95 Typical High $2,884.03 | Professional | None | $616.60 | $707.95 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $4,570.88 | Facility | None | $1,445.44 | $1,479.11 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $1,445.44 Typical High $1,737.80 | Professional | None | $389.05 | $1,445.44 | $1,737.80 |
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 $363.08 Median $1,148.15 Typical High $2,344.23 | Professional | None | $363.08 | $1,148.15 | $2,344.23 |
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 $213.80 Median $489.78 Typical High $2,290.87 | Professional | 52 · Reduced service | $213.80 | $489.78 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $199.53 Typical High $912.01 | Professional | 53 · Discontinued | $85.11 | $199.53 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $741.31 Typical High $3,467.37 | Professional | 54 · Surgery only | $316.23 | $741.31 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $147.91 Typical High $691.83 | Professional | 55 · Aftercare only | $64.57 | $147.91 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $100.00 Typical High $457.09 | Professional | 56 · Pre-op care only | $42.66 | $100.00 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $691.83 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $295.12 | $691.83 | $3,235.94 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,290.87 Median $4,073.80 Typical High $12,589.25 | Facility | 50 · Both sides | $2,290.87 | $4,073.80 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $5,128.61 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $5,128.61 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $2,951.21 | Professional | 54 · Surgery only | $501.19 | $602.56 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $275.42 Typical High $338.84 | Professional | 55 · Aftercare only | $54.95 | $275.42 | $338.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $3,311.31 Typical High $3,981.07 | Professional | 63 · Small infant | $660.69 | $3,311.31 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $1,905.46 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $389.05 | $1,905.46 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $446.68 Typical High $524.81 | Professional | 80 · Assistant surgeon | $91.20 | $446.68 | $524.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $436.52 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $104.71 | $436.52 | $549.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $446.68 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $446.68 | $549.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $371.54 Typical High $467.74 | Professional | AS · PA/NP assist | $75.86 | $371.54 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $489.78 Typical High $2,290.87 | Professional | 52 · Reduced service | $218.78 | $489.78 | $2,290.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $199.53 Typical High $912.01 | Professional | 53 · Discontinued | $87.10 | $199.53 | $912.01 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $741.31 Typical High $3,467.37 | Professional | 54 · Surgery only | $331.13 | $741.31 | $3,467.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $147.91 Typical High $691.83 | Professional | 55 · Aftercare only | $66.07 | $147.91 | $691.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $100.00 Typical High $457.09 | Professional | 56 · Pre-op care only | $43.65 | $100.00 | $457.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $691.83 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $309.03 | $691.83 | $3,235.94 |
Where Idaho sits
The same service costs 5.8 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· 9th of 51
$1,950
AK $3,548NE $617
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.