How much rates vary
Facilitymedian $1,514 · 10th to 90th $776 to $4,266Professionalmedian $1,479 · 10th to 90th $1,122 to $2,089
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 $1,174.90 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,174.90 | $2,089.30 | $2,089.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $4,073.80 | Facility | None | $2,398.83 | $2,570.40 | $4,073.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,548.82 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,348.96 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,495.41 | Facility | None | $1,071.52 | $2,089.30 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,778.28 | $2,089.30 |
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 $1,318.26 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,318.26 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,621.81 | $1,862.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,412.54 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $812.83 | Facility | None | $776.25 | $776.25 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | None | $776.25 | $776.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,949.84 | Professional | None | $933.25 | $1,348.96 | $1,949.84 |
18 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 $588.84 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $588.84 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $234.42 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $870.96 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $173.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $117.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $812.83 | $1,479.11 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,630.27 Typical High $2,754.23 | Professional | 50 · Both sides | $2,187.76 | $2,630.27 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,548.82 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,318.26 | $1,548.82 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $173.78 | $181.97 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,096.48 Typical High $1,148.15 | Professional | 62 · Two surgeons | $912.01 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,778.28 Median $2,089.30 Typical High $2,187.76 | Professional | 63 · Small infant | $1,778.28 | $2,089.30 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,230.27 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $588.84 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $234.42 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $891.25 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $177.83 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $117.49 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $831.76 | $1,479.11 | $1,479.11 |
Where Idaho sits
The same service costs 5.6 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· 14th of 51
$1,479
AK $3,715UT $661
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.