How much rates vary
Facilitymedian $2,138 · 10th to 90th $933 to $6,026Professionalmedian $794 · 10th to 90th $234 to $1,380
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 $5,495.41 Typical High $7,079.46 | Facility | None | $1,412.54 | $5,495.41 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,380.38 Typical High $1,380.38 | Professional | None | $602.56 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $3,311.31 Typical High $12,882.50 | Facility | None | $2,290.87 | $3,311.31 | $12,882.50 |
BCBS Idaho Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $1,148.15 | Professional | None | $234.42 | $275.42 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $891.25 | Professional | None | $676.08 | $794.33 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,380.38 Typical High $6,456.54 | Facility | None | $588.84 | $1,380.38 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $1,380.38 Typical High $1,380.38 | Professional | None | $363.08 | $1,380.38 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $204.17 Typical High $239.88 | Professional | None | $30.20 | $204.17 | $239.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | None | $977.24 | $1,148.15 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $5,128.61 | Facility | None | $275.42 | $281.84 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | None | $234.42 | $275.42 | $275.42 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,818.38 | Facility | None | $1,412.54 | $1,819.70 | $2,818.38 |
United Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
20 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 $363.08 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $363.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $147.91 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $549.54 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $109.65 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $72.44 | $138.04 | $138.04 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $398.11 Typical High $416.87 | Professional | 50 · Both sides | $354.81 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $213.80 | $234.42 | $251.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $27.54 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $27.54 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 62 · Two surgeons | $147.91 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $316.23 Typical High $331.13 | Professional | 63 · Small infant | $281.84 | $316.23 | $331.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $186.21 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $165.96 | $186.21 | $194.98 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | 80 · Assistant surgeon | $38.02 | $41.69 | $44.67 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | 81 · Minimal assistant surgeon | $38.02 | $41.69 | $44.67 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $38.02 | $41.69 | $44.67 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $35.48 Typical High $38.02 | Professional | AS · PA/NP assist | $32.36 | $35.48 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $363.08 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $147.91 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $549.54 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $109.65 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $72.44 | $138.04 | $138.04 |
Where Idaho sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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
$794
AK $2,344HI $224
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.