How much rates vary
Facilitymedian $1,445 · 10th to 90th $741 to $5,495Professionalmedian $617 · 10th to 90th $389 to $977
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 $616.60 Median $616.60 Typical High $977.24 | Professional | None | $616.60 | $616.60 | $977.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $6,025.60 | Facility | None | $1,445.44 | $2,754.23 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,000.00 | Professional | None | $489.78 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $724.44 | Professional | None | $323.59 | $457.09 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $4,466.84 | Facility | None | $302.00 | $741.31 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $977.24 | Professional | None | $446.68 | $616.60 | $977.24 |
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 $512.86 Median $512.86 Typical High $891.25 | Facility | None | $512.86 | $512.86 | $891.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,122.02 | Professional | None | $446.68 | $776.25 | $1,122.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $7,585.78 | Facility | None | $3,890.45 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $912.01 | Professional | None | $489.78 | $616.60 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $4,570.88 | Facility | None | $426.58 | $436.52 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $1,445.44 | Professional | None | $426.58 | $537.03 | $1,445.44 |
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 $316.23 Median $489.78 Typical High $831.76 | Professional | None | $316.23 | $489.78 | $831.76 |
24 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 $309.03 Median $309.03 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $309.03 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $741.31 | Professional | 54 · Surgery only | $467.74 | $467.74 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $691.83 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,137.96 Median $4,073.80 Typical High $9,120.11 | Facility | 50 · Both sides | $2,137.96 | $4,073.80 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,148.15 Typical High $1,513.56 | Professional | 50 · Both sides | $707.95 | $1,148.15 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $426.58 | $501.19 | $691.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $57.54 Typical High $112.20 | Professional | 55 · Aftercare only | $48.98 | $57.54 | $112.20 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $363.08 Typical High $707.95 | Professional | 62 · Two surgeons | $295.12 | $363.08 | $707.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $575.44 Median $691.83 Typical High $1,148.15 | Professional | 63 · Small infant | $575.44 | $691.83 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $331.13 | $407.38 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $309.03 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $125.89 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $741.31 | Professional | 54 · Surgery only | $467.74 | $467.74 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,096.48 Typical High $1,698.24 | Professional | 50 · Both sides | $1,096.48 | $1,096.48 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $794.33 | Professional | 54 · Surgery only | $512.86 | $512.86 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | 62 · Two surgeons | $457.09 | $457.09 | $707.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $851.14 |
Where Idaho sits
The same service costs 5.5 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· 7th of 51
$724
AK $1,585UT $288
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.