How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,089 to $14,125Professionalmedian $2,042 · 10th to 90th $1,445 to $2,455
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,348.96 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,570.40 | Professional | None | $1,995.26 | $2,344.23 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,905.46 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,290.87 Typical High $5,495.41 | Facility | None | $1,096.48 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,137.96 | $2,344.23 |
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 $1,862.09 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,862.09 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,137.96 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,995.26 | $1,995.26 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $10,964.78 | Facility | None | $1,096.48 | $1,122.02 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,096.48 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,862.09 | $2,570.40 |
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 $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $676.08 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $269.15 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,000.00 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $199.53 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $134.90 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $933.25 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $7,585.78 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $7,585.78 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,630.78 Typical High $4,786.30 | Professional | 50 · Both sides | $3,090.30 | $3,630.78 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,187.76 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,187.76 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $257.04 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,951.21 Typical High $3,090.30 | Professional | 63 · Small infant | $2,454.71 | $2,951.21 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $389.05 Typical High $407.38 | Professional | 80 · Assistant surgeon | $331.13 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $389.05 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $331.13 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $389.05 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $331.13 Typical High $346.74 | Professional | AS · PA/NP assist | $281.84 | $331.13 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,318.26 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $263.03 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,621.81 | $1,621.81 |
Where Idaho sits
The same service costs 6.2 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· 16th of 51
$2,239
AK $5,248UT $851
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.