How much rates vary
Facilitymedian $832 · 10th to 90th $200 to $3,548Professionalmedian $204 · 10th to 90th $132 to $339
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 $199.53 Median $4,466.84 Typical High $7,079.46 | Facility | None | $199.53 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $338.84 Typical High $338.84 | Professional | None | $123.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $100.00 | $257.04 | $257.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $4,466.84 | Facility | None | $912.01 | $1,258.93 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $234.42 | Professional | None | $181.97 | $213.80 | $234.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $199.53 | Professional | 54 · Surgery only | $165.96 | $190.55 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $194.98 | Professional | None | $141.25 | $169.82 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $338.84 Typical High $5,495.41 | Facility | None | $158.49 | $338.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $338.84 | Professional | None | $158.49 | $218.78 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $117.49 | $257.04 | $257.04 |
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 $162.18 Median $199.53 Typical High $199.53 | Facility | None | $162.18 | $199.53 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | None | $199.53 | $199.53 | $218.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $2,818.38 | Facility | None | $75.86 | $95.50 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $213.80 | Professional | None | $95.50 | $95.50 | $213.80 |
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 $125.89 Median $169.82 Typical High $257.04 | Professional | None | $125.89 | $169.82 | $257.04 |
13 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.38 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $21.38 | $22.39 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $114.82 Median $131.83 Typical High $138.04 | Professional | 62 · Two surgeons | $114.82 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $251.19 Typical High $269.15 | Professional | 63 · Small infant | $218.78 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $33.88 Typical High $35.48 | Professional | 80 · Assistant surgeon | $29.51 | $33.88 | $35.48 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $33.88 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $29.51 | $33.88 | $35.48 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $33.88 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $33.88 | $35.48 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $28.84 Typical High $30.20 | Professional | AS · PA/NP assist | $25.12 | $28.84 | $30.20 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 22 · Increased work | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 62 · Two surgeons | $138.04 | $138.04 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 63 · Small infant | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
Where Idaho sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 11th of 51
$204
AK $468UT $95.50
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.