How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,096 to $9,120Professionalmedian $1,096 · 10th to 90th $692 to $1,380
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 $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | None | $977.24 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $10,000.00 | Facility | None | $1,949.84 | $3,548.13 | $10,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,230.27 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,023.29 | Professional | None | $512.86 | $891.25 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,380.38 Typical High $5,495.41 | Facility | None | $616.60 | $1,380.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,380.38 | Professional | None | $912.01 | $1,071.52 | $1,380.38 |
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 $891.25 Median $1,096.48 Typical High $1,096.48 | Facility | None | $891.25 | $1,096.48 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,584.89 | Professional | None | $954.99 | $1,096.48 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,456.54 Median $9,120.11 Typical High $12,589.25 | Facility | None | $6,456.54 | $9,120.11 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,288.25 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $6,918.31 | Facility | None | $524.81 | $537.03 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $2,238.72 | Professional | None | $524.81 | $831.76 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,288.25 | Professional | None | $691.83 | $891.25 | $1,288.25 |
19 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 $489.78 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $724.44 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $676.08 | $954.99 | $954.99 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,884.03 Median $3,890.45 Typical High $15,135.61 | Facility | 50 · Both sides | $2,884.03 | $3,890.45 | $15,135.61 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,778.28 Typical High $2,398.83 | Professional | 50 · Both sides | $1,513.56 | $1,778.28 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,445.44 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $158.49 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $158.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,000.00 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,412.54 Typical High $1,905.46 | Professional | 63 · Small infant | $1,174.90 | $1,412.54 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $199.53 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $741.31 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $100.00 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $691.83 | $954.99 | $954.99 |
Where Idaho sits
The same service costs 8.5 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
$1,230
WY $3,020UT $355
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.