How much rates vary
Facilitymedian $2,344 · 10th to 90th $933 to $8,913Professionalmedian $794 · 10th to 90th $550 to $977
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $977.24 | Professional | None | $549.54 | $977.24 | $977.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $8,912.51 | Facility | None | $2,344.23 | $3,801.89 | $8,912.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,000.00 | Professional | None | $758.58 | $912.01 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,905.46 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $851.14 | Professional | None | $616.60 | $707.95 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $5,495.41 | Facility | None | $537.03 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $977.24 | Professional | None | $645.65 | $912.01 | $977.24 |
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 $724.44 Median $891.25 Typical High $891.25 | Facility | None | $724.44 | $891.25 | $891.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Professional | None | $891.25 | $891.25 | $1,513.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,165.95 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $954.99 | Professional | None | $758.58 | $758.58 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $426.58 Typical High $7,079.46 | Facility | None | $416.87 | $426.58 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $630.96 | Professional | None | $416.87 | $416.87 | $630.96 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,023.29 | Professional | None | $489.78 | $707.95 | $1,023.29 |
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 $288.40 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $288.40 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $117.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $436.52 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $87.10 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $57.54 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $407.38 | $691.83 | $691.83 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $5,370.32 Typical High $15,135.61 | Facility | 50 · Both sides | $3,548.13 | $5,370.32 | $15,135.61 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $1,659.59 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $707.95 | $851.14 | $891.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $93.33 | $100.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,122.02 Typical High $1,202.26 | Professional | 63 · Small infant | $954.99 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $660.69 | $691.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $158.49 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $158.49 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $151.36 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $125.89 | $151.36 | $158.49 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $151.36 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $151.36 | $158.49 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $134.90 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $489.78 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $97.72 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $457.09 | $691.83 | $691.83 |
Where Idaho sits
The same service costs 10.0 times more in Oklahoma 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
$955
OK $3,631UT $363
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.