How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,122 to $8,913Professionalmedian $1,122 · 10th to 90th $676 to $1,778
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 $676.08 Median $1,778.28 Typical High $1,778.28 | Professional | None | $676.08 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $8,912.51 | Facility | None | $2,344.23 | $3,801.89 | $8,912.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,202.26 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,905.46 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,000.00 | Professional | None | $724.44 | $870.96 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,778.28 Typical High $5,495.41 | Facility | None | $616.60 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,778.28 | Professional | None | $851.14 | $1,148.15 | $1,778.28 |
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 $912.01 Median $1,122.02 Typical High $1,122.02 | Facility | None | $912.01 | $1,122.02 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,165.95 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,230.27 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $7,079.46 | Facility | None | $537.03 | $549.54 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,148.15 | Professional | None | $537.03 | $537.03 | $1,148.15 |
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 $645.65 Median $851.14 Typical High $1,288.25 | Professional | None | $645.65 | $851.14 | $1,288.25 |
30 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 $346.74 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $346.74 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $138.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $524.81 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $104.71 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $69.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $489.78 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $5,370.32 Typical High $15,135.61 | Facility | 50 · Both sides | $3,548.13 | $5,370.32 | $15,135.61 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 50 · Both sides | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $125.89 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 62 · Two surgeons | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,412.54 Typical High $1,513.56 | Professional | 63 · Small infant | $1,258.93 | $1,412.54 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $891.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $190.55 Typical High $199.53 | Professional | 80 · Assistant surgeon | $165.96 | $190.55 | $199.53 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $190.55 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $165.96 | $190.55 | $199.53 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $190.55 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $190.55 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $162.18 Typical High $169.82 | Professional | AS · PA/NP assist | $141.25 | $162.18 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $416.87 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $169.82 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $630.96 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $125.89 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $85.11 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $588.84 | $1,230.27 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 22 · Increased work | $1,288.25 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 50 · Both sides | $1,778.28 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 62 · Two surgeons | $741.31 | $741.31 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 63 · Small infant | $1,288.25 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Idaho sits
The same service costs 5.9 times more in Alaska than in Texas. 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
$1,148
AK $2,512TX $427
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.