How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,096 to $8,913Professionalmedian $1,122 · 10th to 90th $676 to $1,738
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 $602.56 Median $1,737.80 Typical High $1,737.80 | Professional | None | $602.56 | $1,737.80 | $1,737.80 |
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 $1,023.29 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,174.90 | $1,230.27 |
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 $851.14 Typical High $1,000.00 | Professional | None | $724.44 | $851.14 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $5,495.41 | Facility | None | $602.56 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,737.80 | Professional | None | $831.76 | $1,148.15 | $1,737.80 |
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 $891.25 Median $1,096.48 Typical High $1,096.48 | Facility | None | $891.25 | $1,096.48 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,096.48 | $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 $524.81 Median $537.03 Typical High $7,079.46 | Facility | None | $524.81 | $537.03 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,122.02 | Professional | None | $524.81 | $524.81 | $1,122.02 |
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 $831.76 Typical High $1,288.25 | Professional | None | $645.65 | $831.76 | $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 $338.84 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $338.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $134.90 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $512.86 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $102.33 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $67.61 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $478.63 | $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 $1,737.80 Typical High $1,862.09 | Professional | 50 · Both sides | $1,548.82 | $1,737.80 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $123.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | 62 · Two surgeons | $645.65 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,380.38 Typical High $1,479.11 | Professional | 63 · Small infant | $1,230.27 | $1,380.38 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 80 · Assistant surgeon | $162.18 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $162.18 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $158.49 Typical High $169.82 | Professional | AS · PA/NP assist | $138.04 | $158.49 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $416.87 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $165.96 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $616.60 | $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 $83.18 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $83.18 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $575.44 | $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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 50 · Both sides | $1,737.80 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 62 · Two surgeons | $724.44 | $724.44 | $724.44 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
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 $2,455TX $417
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.