How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $14,125Professionalmedian $692 · 10th to 90th $490 to $851
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 $4,677.35 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,677.35 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $851.14 | Professional | None | $501.19 | $851.14 | $851.14 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,630.78 Median $5,888.44 Typical High $14,791.08 | Facility | None | $3,630.78 | $5,888.44 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | None | $660.69 | $794.33 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $741.31 | Professional | None | $537.03 | $630.96 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $12,022.64 | Facility | None | $457.09 | $851.14 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $851.14 | Professional | None | $575.44 | $831.76 | $851.14 |
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 $630.96 Median $776.25 Typical High $776.25 | Facility | None | $630.96 | $776.25 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,318.26 | Professional | None | $776.25 | $776.25 | $1,318.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $10,964.78 | Facility | None | $371.54 | $380.19 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $549.54 | Professional | None | $371.54 | $371.54 | $549.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $891.25 | Professional | None | $426.58 | $616.60 | $891.25 |
23 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 $251.19 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $251.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $102.33 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $380.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $75.86 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $50.12 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $354.81 | $602.56 | $602.56 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $8,511.38 Typical High $22,387.21 | Facility | 50 · Both sides | $5,128.61 | $8,511.38 | $22,387.21 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $1,445.44 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $741.31 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $83.18 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $83.18 | $87.10 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $549.54 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $549.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $831.76 Median $1,000.00 Typical High $1,047.13 | Professional | 63 · Small infant | $831.76 | $1,000.00 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $138.04 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $131.83 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $112.20 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $131.83 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $117.49 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $281.84 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $114.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $57.54 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $602.56 |
Where Idaho sits
The same service costs 9.5 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· 15th of 51
$832
OK $3,236UT $339
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.