How much rates vary
Facilitymedian $912 · 10th to 90th $550 to $4,467Professionalmedian $1,738 · 10th to 90th $1,202 to $2,399
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,380.38 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $4,897.79 | Facility | None | $3,630.78 | $4,073.80 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,819.70 | $2,187.76 |
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 $1,318.26 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,548.82 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $5,495.41 | Facility | None | $912.01 | $2,398.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,380.38 | $2,041.74 | $2,398.83 |
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 $1,584.89 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,584.89 | $1,949.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,949.84 | $1,949.84 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,659.59 | $2,041.74 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Facility | None | $912.01 | $912.01 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,348.96 | Professional | None | $912.01 | $912.01 | $1,348.96 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,238.72 | Professional | None | $977.24 | $1,412.54 | $2,238.72 |
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 $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $691.83 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $275.42 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,047.13 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $208.93 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $138.04 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $977.24 | $1,698.24 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,019.95 Typical High $3,235.94 | Professional | 50 · Both sides | $2,630.27 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $199.53 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $199.53 | $218.78 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,258.93 Typical High $1,348.96 | Professional | 62 · Two surgeons | $1,096.48 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,089.30 Median $2,398.83 Typical High $2,570.40 | Professional | 63 · Small infant | $2,089.30 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $346.74 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $346.74 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $323.59 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $275.42 | $323.59 | $346.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $323.59 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $323.59 | $346.74 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $269.15 Typical High $295.12 | Professional | AS · PA/NP assist | $234.42 | $269.15 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $691.83 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $275.42 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,047.13 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $208.93 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $138.04 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $977.24 | $1,698.24 | $1,698.24 |
Where Idaho sits
The same service costs 6.6 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· 14th of 51
$1,698
AK $4,365TX $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.