How much rates vary
Facilitymedian $1,660 · 10th to 90th $676 to $5,495Professionalmedian $2,188 · 10th to 90th $1,288 to $2,754
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,479.11 | $2,754.23 | $2,754.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,548.82 Median $3,388.44 Typical High $5,888.44 | Facility | None | $1,548.82 | $3,388.44 | $5,888.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,344.23 | $2,454.71 |
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 $1,258.93 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,584.89 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,023.29 | $2,754.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,479.11 | $2,754.23 | $2,754.23 |
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 $1,778.28 Median $2,187.76 Typical High $2,187.76 | Facility | None | $1,778.28 | $2,187.76 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,187.76 | $2,818.38 |
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 $2,089.30 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,089.30 | $2,454.71 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $3,801.89 | Facility | None | $1,047.13 | $1,071.52 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,071.52 | $1,778.28 |
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 $954.99 Median $1,513.56 Typical High $2,290.87 | Professional | None | $954.99 | $1,513.56 | $2,290.87 |
23 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 $741.31 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $741.31 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $295.12 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,096.48 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $218.78 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $147.91 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,290.87 Median $5,128.61 Typical High $8,709.64 | Facility | 50 · Both sides | $2,290.87 | $5,128.61 | $8,709.64 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,388.44 Typical High $3,715.35 | Professional | 50 · Both sides | $3,019.95 | $3,388.44 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,412.54 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,258.93 | $1,412.54 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,691.53 Typical High $2,951.21 | Professional | 63 · Small infant | $2,454.71 | $2,691.53 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,584.89 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 80 · Assistant surgeon | $323.59 | $363.08 | $398.11 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $323.59 | $363.08 | $398.11 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $363.08 | $398.11 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $309.03 Typical High $338.84 | Professional | AS · PA/NP assist | $275.42 | $309.03 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $741.31 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $295.12 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,096.48 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $218.78 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $147.91 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,949.84 | $1,949.84 |
Where Idaho sits
The same service costs 5.8 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· 8th of 51
$2,188
AK $4,898TX $851
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.