How much rates vary
Facilitymedian $955 · 10th to 90th $550 to $4,266Professionalmedian $1,995 · 10th to 90th $1,202 to $2,512
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 $1,348.96 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $4,365.16 | Facility | None | $2,691.53 | $2,951.21 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,862.09 | $2,137.96 | $2,238.72 |
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 $1,148.15 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,445.44 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,511.89 Typical High $5,495.41 | Facility | None | $891.25 | $2,511.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,511.89 | $2,511.89 |
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 $1,621.81 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,995.26 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,995.26 | $1,995.26 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,238.72 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Facility | None | $954.99 | $954.99 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,621.81 | Professional | None | $954.99 | $1,047.13 | $1,621.81 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,995.26 | Professional | None | $891.25 | $1,318.26 | $1,995.26 |
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 $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $676.08 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $269.15 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,000.00 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $199.53 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $134.90 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $933.25 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,090.30 Typical High $3,388.44 | Professional | 50 · Both sides | $2,754.23 | $3,090.30 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,862.09 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $1,862.09 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,288.25 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,148.15 | $1,288.25 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,238.72 Median $2,454.71 Typical High $2,691.53 | Professional | 63 · Small infant | $2,238.72 | $2,454.71 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,445.44 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | 80 · Assistant surgeon | $295.12 | $331.13 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $295.12 | $331.13 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $331.13 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | AS · PA/NP assist | $251.19 | $281.84 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $676.08 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $269.15 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,000.00 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $199.53 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $134.90 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $933.25 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 21.9 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· 9th of 51
$1,995
AK $4,467TX $204
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.