How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,259 to $8,913Professionalmedian $1,148 · 10th to 90th $794 to $1,413
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 $741.31 Median $1,412.54 Typical High $1,412.54 | Professional | None | $741.31 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,715.35 Typical High $10,000.00 | Facility | None | $2,344.23 | $3,715.35 | $10,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,318.26 | $1,412.54 |
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 $891.25 Median $1,023.29 Typical High $1,230.27 | Professional | None | $891.25 | $1,023.29 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $5,495.41 | Facility | None | $776.25 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,412.54 | Professional | None | $933.25 | $1,380.38 | $1,412.54 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,258.93 | $2,187.76 |
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 $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $7,079.46 | Facility | None | $602.56 | $616.60 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $912.01 | Professional | None | $602.56 | $602.56 | $912.01 |
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 $691.83 Median $1,023.29 Typical High $1,479.11 | Professional | None | $691.83 | $1,023.29 | $1,479.11 |
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 $416.87 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $416.87 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $165.96 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $630.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $125.89 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $83.18 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $588.84 | $1,000.00 | $1,000.00 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $5,495.41 Typical High $15,135.61 | Facility | 50 · Both sides | $3,548.13 | $5,495.41 | $15,135.61 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,041.74 Typical High $2,398.83 | Professional | 50 · Both sides | $1,698.24 | $2,041.74 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $141.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | 63 · Small infant | $1,380.38 | $1,621.81 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $218.78 Typical High $229.09 | Professional | 80 · Assistant surgeon | $181.97 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $218.78 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $181.97 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $218.78 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $467.74 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $186.21 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $707.95 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $141.25 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $660.69 | $1,000.00 | $1,000.00 |
Where Idaho sits
The same service costs 6.3 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· 14th of 51
$1,349
OK $3,311UT $525
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.