How much rates vary
Facilitymedian $1,288 · 10th to 90th $562 to $5,012Professionalmedian $631 · 10th to 90th $427 to $813
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $812.83 Typical High $812.83 | Professional | None | $426.58 | $812.83 | $812.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $5,011.87 | Facility | None | $1,288.25 | $2,238.72 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $676.08 | Professional | None | $549.54 | $645.65 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,584.89 | Facility | None | $1,047.13 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | None | $426.58 | $489.78 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $812.83 Typical High $5,495.41 | Facility | None | $398.11 | $812.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $812.83 Typical High $812.83 | Professional | None | $426.58 | $812.83 | $812.83 |
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 $489.78 Median $602.56 Typical High $602.56 | Facility | None | $489.78 | $602.56 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,388.44 Median $4,897.79 Typical High $6,309.57 | Facility | None | $3,388.44 | $4,897.79 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $812.83 | Professional | None | $630.96 | $660.69 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $3,801.89 | Facility | None | $288.40 | $288.40 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $1,071.52 | Professional | None | $288.40 | $346.74 | $1,071.52 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $870.96 | Professional | None | $380.19 | $537.03 | $870.96 |
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 $213.80 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $213.80 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $85.11 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $316.23 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $63.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $295.12 | $575.44 | $575.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,949.84 Median $3,311.31 Typical High $7,585.78 | Facility | 50 · Both sides | $1,949.84 | $3,311.31 | $7,585.78 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $954.99 Typical High $1,000.00 | Professional | 50 · Both sides | $831.76 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $575.44 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 63 · Small infant | $660.69 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $467.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $102.33 Typical High $107.15 | Professional | 80 · Assistant surgeon | $89.13 | $102.33 | $107.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $102.33 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $89.13 | $102.33 | $107.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $102.33 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $102.33 | $107.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $87.10 Typical High $91.20 | Professional | AS · PA/NP assist | $75.86 | $87.10 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $213.80 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $85.11 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $316.23 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $63.10 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $295.12 | $575.44 | $575.44 |
Where Idaho sits
The same service costs 5.8 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· 9th of 51
$646
AK $1,349UT $234
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.