How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,905 to $13,490Professionalmedian $2,239 · 10th to 90th $1,445 to $3,311
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,621.81 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,884.03 Median $5,011.87 Typical High $13,489.63 | Facility | None | $2,884.03 | $5,011.87 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,511.89 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,818.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,445.44 | $2,187.76 | $2,818.38 |
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 $1,819.70 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,819.70 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,238.72 | $3,311.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $11,220.18 Typical High $16,982.44 | Facility | None | $7,585.78 | $11,220.18 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,630.27 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $9,332.54 | Facility | None | $1,071.52 | $1,071.52 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $5,128.61 | Professional | None | $1,071.52 | $1,698.24 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,698.24 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,862.09 | $2,570.40 |
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 $1,000.00 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,000.00 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,479.11 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $302.00 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,365.16 Median $7,413.10 Typical High $20,417.38 | Facility | 50 · Both sides | $4,365.16 | $7,413.10 | $20,417.38 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,630.78 Typical High $4,897.79 | Professional | 50 · Both sides | $3,090.30 | $3,630.78 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,137.96 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,778.28 | $2,137.96 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $234.42 Typical High $331.13 | Professional | 55 · Aftercare only | $199.53 | $234.42 | $331.13 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,398.83 Median $2,818.38 Typical High $3,981.07 | Professional | 63 · Small infant | $2,398.83 | $2,818.38 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $380.19 Typical High $524.81 | Professional | 80 · Assistant surgeon | $316.23 | $380.19 | $524.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $380.19 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $316.23 | $380.19 | $524.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $380.19 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $380.19 | $524.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $446.68 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,023.29 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $407.38 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,548.82 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $309.03 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $204.17 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 8.3 times more in Wyoming 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· 11th of 51
$2,512
WY $5,623UT $676
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.