How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $3,802Professionalmedian $1,413 · 10th to 90th $1,047 to $1,995
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 $1,071.52 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $3,467.37 Typical High $4,168.69 | Facility | None | $3,162.28 | $3,467.37 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,479.11 | $1,778.28 |
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 $1,122.02 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,288.25 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $5,495.41 | Facility | None | $741.31 | $1,995.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,584.89 | $1,995.26 |
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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,584.89 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Facility | None | $741.31 | $741.31 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Professional | None | $741.31 | $741.31 | $1,148.15 |
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 $891.25 Median $1,288.25 Typical High $1,905.46 | Professional | None | $891.25 | $1,288.25 | $1,905.46 |
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 $562.34 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $562.34 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $223.87 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $831.76 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $165.96 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $112.20 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $776.25 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | 50 · Both sides | $2,137.96 | $2,511.89 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,513.56 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,513.56 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $165.96 | $177.83 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $1,995.26 Typical High $2,089.30 | Professional | 63 · Small infant | $1,698.24 | $1,995.26 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $281.84 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $269.15 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $223.87 | $269.15 | $281.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $269.15 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $269.15 | $281.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $229.09 Typical High $239.88 | Professional | AS · PA/NP assist | $190.55 | $229.09 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $562.34 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $229.09 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $851.14 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $169.82 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $114.82 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $794.33 | $1,412.54 | $1,412.54 |
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· 13th of 51
$1,413
AK $3,548UT $631
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.