How much rates vary
Facilitymedian $457 · 10th to 90th $229 to $1,514Professionalmedian $490 · 10th to 90th $309 to $661
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $660.69 | Professional | None | $371.54 | $537.03 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $239.88 Median $645.65 Typical High $1,513.56 | Facility | None | $239.88 | $645.65 | $1,513.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $691.83 | Professional | None | $398.11 | $562.34 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $309.03 | Facility | None | $204.17 | $229.09 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $489.78 | Professional | None | $245.47 | $389.05 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $537.03 Typical High $5,495.41 | Facility | None | $263.03 | $537.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $660.69 | Professional | None | $346.74 | $512.86 | $660.69 |
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 $416.87 Median $416.87 Typical High $602.56 | Facility | None | $416.87 | $416.87 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $758.58 | Professional | None | $363.08 | $524.81 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,905.46 | Facility | None | $977.24 | $1,380.38 | $1,905.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $616.60 | Professional | None | $416.87 | $512.86 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $1,230.27 | Facility | None | $288.40 | $295.12 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $446.68 | Professional | None | $165.96 | $288.40 | $446.68 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $575.44 | Professional | None | $269.15 | $389.05 | $575.44 |
26 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 $234.42 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $234.42 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $107.15 Typical High $131.83 | Professional | 53 · Discontinued | $95.50 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $53.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $457.09 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $354.81 Median $891.25 Typical High $2,290.87 | Facility | 50 · Both sides | $354.81 | $891.25 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $691.83 Typical High $1,023.29 | Professional | 50 · Both sides | $575.44 | $691.83 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $354.81 | $501.19 | $691.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $56.23 Typical High $75.86 | Professional | 55 · Aftercare only | $44.67 | $56.23 | $75.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $457.09 Median $562.34 Typical High $741.31 | Professional | 63 · Small infant | $457.09 | $562.34 | $741.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $478.63 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $74.13 Typical High $100.00 | Professional | 80 · Assistant surgeon | $63.10 | $74.13 | $100.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $93.33 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $61.66 | $93.33 | $123.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $74.13 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $74.13 | $97.72 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $63.10 Typical High $104.71 | Professional | AS · PA/NP assist | $52.48 | $63.10 | $104.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $234.42 | $269.15 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $107.15 Typical High $131.83 | Professional | 53 · Discontinued | $95.50 | $107.15 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $398.11 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $53.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $53.70 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | 50 · Both sides | $933.25 | $933.25 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $436.52 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $75.86 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $575.44 |
Where Idaho sits
The same service costs 5.2 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· 9th of 51
$490
AK $1,000UT $191
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.