How much rates vary
Facilitymedian $2,042 · 10th to 90th $457 to $7,762Professionalmedian $891 · 10th to 90th $692 to $1,288
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,288.25 Typical High $1,288.25 | Professional | None | $707.95 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $2,344.23 Typical High $9,120.11 | Facility | None | $524.81 | $2,344.23 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,096.48 | Professional | None | $851.14 | $1,000.00 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $977.24 | Professional | None | $707.95 | $812.83 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,288.25 Typical High $5,495.41 | Facility | None | $676.08 | $1,288.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,288.25 | Professional | None | $707.95 | $1,071.52 | $1,288.25 |
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 $794.33 Median $977.24 Typical High $977.24 | Facility | None | $794.33 | $977.24 | $977.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,698.24 | Professional | None | $977.24 | $977.24 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | None | $851.14 | $851.14 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $467.74 Typical High $1,659.59 | Facility | None | $457.09 | $467.74 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,202.26 | Professional | None | $588.84 | $831.76 | $1,202.26 |
20 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 $354.81 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $354.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $141.25 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $524.81 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $107.15 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $70.79 | $128.82 | $128.82 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $3,467.37 Typical High $13,489.63 | Facility | 50 · Both sides | $776.25 | $3,467.37 | $13,489.63 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,584.89 Typical High $1,905.46 | Professional | 50 · Both sides | $1,318.26 | $1,584.89 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $109.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,047.13 Median $1,230.27 Typical High $1,318.26 | Professional | 63 · Small infant | $1,047.13 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $724.44 | $758.58 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $173.78 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $165.96 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $138.04 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $165.96 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $147.91 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $354.81 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $141.25 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $537.03 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $107.15 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $70.79 | $128.82 | $128.82 |
Where Idaho sits
The same service costs 3.9 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· 16th of 51
$977
AK $2,239UT $575
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.