How much rates vary
Facilitymedian $5,623 · 10th to 90th $575 to $18,621Professionalmedian $891 · 10th to 90th $676 to $1,259
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 $1,258.93 Typical High $1,258.93 | Professional | None | $707.95 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,318.26 Median $6,760.83 Typical High $23,988.33 | Facility | None | $1,318.26 | $6,760.83 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,071.52 | Professional | None | $851.14 | $1,000.00 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,495.41 | $6,165.95 | $8,317.64 |
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 $1,258.93 Typical High $5,495.41 | Facility | None | $676.08 | $1,258.93 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,258.93 | Professional | None | $707.95 | $1,071.52 | $1,258.93 |
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 $954.99 Typical High $954.99 | Facility | None | $794.33 | $954.99 | $954.99 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,698.24 | Professional | None | $954.99 | $954.99 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $20,892.96 Typical High $30,199.52 | Facility | None | $8,511.38 | $20,892.96 | $30,199.52 |
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 $4,786.30 | Facility | None | $457.09 | $467.74 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | None | $457.09 | $457.09 | $707.95 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $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 $104.71 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $104.71 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $70.79 | $125.89 | $125.89 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,862.09 Median $10,000.00 Typical High $36,307.81 | Facility | 50 · Both sides | $1,862.09 | $10,000.00 | $36,307.81 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,584.89 Typical High $1,862.09 | Professional | 50 · Both sides | $1,318.26 | $1,584.89 | $1,862.09 |
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 $107.15 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $107.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | 63 · Small infant | $1,047.13 | $1,230.27 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $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 $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $70.79 | $125.89 | $125.89 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in New York. 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 $2,239NY $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.