How much rates vary
Facilitymedian $1,862 · 10th to 90th $933 to $4,467Professionalmedian $1,445 · 10th to 90th $1,023 to $1,738
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,584.89 | $1,584.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $3,388.44 Typical High $4,168.69 | Facility | None | $3,162.28 | $3,388.44 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,479.11 | $1,737.80 |
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 $1,096.48 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,318.26 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $5,495.41 | Facility | None | $1,023.29 | $1,584.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,584.89 | $1,737.80 |
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 $1,258.93 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,258.93 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,548.82 | $1,778.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,412.54 | $1,737.80 |
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 $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 $891.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $891.25 | $1,258.93 | $1,862.09 |
21 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 $524.81 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $524.81 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $794.33 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $158.49 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $104.71 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $741.31 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,454.71 Typical High $2,570.40 | Professional | 50 · Both sides | $2,089.30 | $2,454.71 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,479.11 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,995.26 Typical High $2,089.30 | Professional | 63 · Small infant | $1,659.59 | $1,995.26 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,148.15 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $275.42 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $223.87 | $263.03 | $275.42 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $263.03 | $275.42 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $524.81 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $794.33 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $158.49 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $104.71 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $741.31 | $1,096.48 | $1,096.48 |
Where Idaho sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 11th of 51
$1,549
AK $3,715TX $575
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.