How much rates vary
Facilitymedian $1,445 · 10th to 90th $457 to $5,495Professionalmedian $1,047 · 10th to 90th $676 to $1,349
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 $933.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $933.25 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $6,025.60 | Facility | None | $1,445.44 | $2,691.53 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,548.82 | Professional | None | $977.24 | $1,174.90 | $1,548.82 |
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 $489.78 Median $870.96 Typical High $977.24 | Professional | None | $489.78 | $870.96 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $5,495.41 | Facility | None | $616.60 | $1,348.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $891.25 | $1,047.13 | $1,348.96 |
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 $870.96 Median $1,047.13 Typical High $1,047.13 | Facility | None | $870.96 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,548.82 | Professional | None | $912.01 | $1,047.13 | $1,548.82 |
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 $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,230.27 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $4,570.88 | Facility | None | $501.19 | $512.86 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,445.44 | Professional | None | $501.19 | $794.33 | $1,445.44 |
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 $660.69 Median $870.96 Typical High $1,230.27 | Professional | None | $660.69 | $870.96 | $1,230.27 |
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 $467.74 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $467.74 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $190.55 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $707.95 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $93.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $660.69 | $933.25 | $933.25 |
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 $1,479.11 Median $1,698.24 Typical High $2,344.23 | Professional | 50 · Both sides | $1,479.11 | $1,698.24 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,023.29 Typical High $1,412.54 | Professional | 54 · Surgery only | $851.14 | $1,023.29 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $154.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,148.15 Median $1,348.96 Typical High $1,862.09 | Professional | 63 · Small infant | $1,148.15 | $1,348.96 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $794.33 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $660.69 | $794.33 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $251.19 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $251.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $181.97 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $151.36 | $181.97 | $251.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $181.97 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $181.97 | $251.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $478.63 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $194.98 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $724.44 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $144.54 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $95.50 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $676.08 | $933.25 | $933.25 |
Where Idaho sits
The same service costs 7.6 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· 11th of 51
$1,096
AK $2,512UT $331
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.