How much rates vary
Facilitymedian $2,291 · 10th to 90th $759 to $8,511Professionalmedian $562 · 10th to 90th $398 to $692
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 $416.87 Median $691.83 Typical High $691.83 | Professional | None | $416.87 | $691.83 | $691.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,754.23 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $707.95 | Professional | None | $537.03 | $645.65 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $588.84 | Professional | None | $436.52 | $512.86 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $5,495.41 | Facility | None | $371.54 | $691.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $691.83 | Professional | None | $457.09 | $676.08 | $691.83 |
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 $512.86 Median $630.96 Typical High $630.96 | Facility | None | $512.86 | $630.96 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,071.52 | Professional | None | $630.96 | $630.96 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $676.08 | Professional | None | $537.03 | $537.03 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $4,570.88 | Facility | None | $302.00 | $309.03 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $446.68 | Professional | None | $302.00 | $302.00 | $446.68 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $707.95 | Professional | None | $354.81 | $501.19 | $707.95 |
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 $208.93 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $208.93 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $83.18 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $316.23 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $63.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $41.69 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $295.12 | $489.78 | $489.78 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,454.71 Median $3,981.07 Typical High $13,489.63 | Facility | 50 · Both sides | $2,454.71 | $3,981.07 | $13,489.63 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,174.90 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $602.56 | $630.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $70.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $794.33 Typical High $851.14 | Professional | 63 · Small infant | $676.08 | $794.33 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $489.78 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $112.20 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $91.20 | $107.15 | $112.20 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $107.15 | $112.20 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $95.50 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $229.09 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $346.74 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $69.18 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $45.71 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $323.59 | $489.78 | $489.78 |
Where Idaho sits
The same service costs 6.9 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· 14th of 51
$676
AK $1,905UT $275
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.