How much rates vary
Facilitymedian $1,413 · 10th to 90th $832 to $5,012Professionalmedian $851 · 10th to 90th $589 to $1,122
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 $602.56 Median $1,122.02 Typical High $1,122.02 | Professional | None | $602.56 | $1,122.02 | $1,122.02 |
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 $776.25 Median $912.01 Typical High $933.25 | Professional | None | $776.25 | $912.01 | $933.25 |
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 $549.54 Median $660.69 Typical High $741.31 | Professional | None | $549.54 | $660.69 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,122.02 Typical High $5,495.41 | Facility | None | $457.09 | $1,122.02 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,122.02 | Professional | None | $602.56 | $1,122.02 | $1,122.02 |
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 $676.08 Median $831.76 Typical High $831.76 | Facility | None | $676.08 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
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 $831.76 Median $912.01 Typical High $1,122.02 | Professional | None | $831.76 | $912.01 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $3,801.89 | Facility | None | $398.11 | $407.38 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $1,071.52 | Professional | None | $398.11 | $467.74 | $1,071.52 |
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 $489.78 Median $676.08 Typical High $954.99 | Professional | None | $489.78 | $676.08 | $954.99 |
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 $302.00 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $302.00 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $120.23 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $457.09 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $91.20 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $60.26 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $426.58 | $794.33 | $794.33 |
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 $1,148.15 Median $1,318.26 Typical High $1,412.54 | Professional | 50 · Both sides | $1,148.15 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $794.33 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 63 · Small infant | $933.25 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $616.60 | $660.69 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 80 · Assistant surgeon | $123.03 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $123.03 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $141.25 | $151.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | AS · PA/NP assist | $104.71 | $120.23 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $302.00 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $120.23 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $457.09 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $91.20 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $60.26 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $426.58 | $794.33 | $794.33 |
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· 8th of 51
$891
AK $1,862UT $324
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.