How much rates vary
Facilitymedian $12,882 · 10th to 90th $3,802 to $26,303Professionalmedian $5,754 · 10th to 90th $4,074 to $6,918
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 $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $6,606.93 Typical High $6,606.93 | Professional | None | $4,073.80 | $6,606.93 | $6,606.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $10,964.78 Median $15,848.93 Typical High $30,902.95 | Facility | None | $10,964.78 | $15,848.93 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $5,128.61 Median $6,025.60 Typical High $6,456.54 | Professional | None | $5,128.61 | $6,025.60 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $15,135.61 Median $16,982.44 Typical High $23,442.29 | Facility | None | $15,135.61 | $16,982.44 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $4,466.84 Typical High $5,128.61 | Professional | None | $3,890.45 | $4,466.84 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,630.27 | $5,495.41 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $4,073.80 Median $6,606.93 Typical High $7,762.47 | Professional | None | $4,073.80 | $6,606.93 | $7,762.47 |
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 $4,466.84 Median $5,495.41 Typical High $5,495.41 | Facility | None | $4,466.84 | $5,495.41 | $5,495.41 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,079.46 | Professional | None | $5,495.41 | $5,495.41 | $7,079.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,054.61 Median $25,118.86 Typical High $31,622.78 | Facility | None | $19,054.61 | $25,118.86 | $31,622.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,495.41 Median $6,456.54 Typical High $7,762.47 | Professional | None | $5,495.41 | $6,456.54 | $7,762.47 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,818.38 | Facility | None | $2,630.27 | $2,630.27 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $15,848.93 | Professional | None | $2,630.27 | $3,235.94 | $15,848.93 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $6,606.93 | Professional | None | $3,235.94 | $4,570.88 | $6,606.93 |
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 $2,041.74 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $2,041.74 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $812.83 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $3,090.30 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $616.60 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $407.38 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,884.03 | $4,570.88 | $4,570.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $12,882.50 Median $23,988.33 Typical High $45,708.82 | Facility | 50 · Both sides | $12,882.50 | $23,988.33 | $45,708.82 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $7,762.47 Median $8,709.64 Typical High $9,332.54 | Professional | 50 · Both sides | $7,762.47 | $8,709.64 | $9,332.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $4,570.88 Median $5,248.07 Typical High $5,623.41 | Professional | 54 · Surgery only | $4,570.88 | $5,248.07 | $5,623.41 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $512.86 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,162.28 Median $3,630.78 Typical High $3,890.45 | Professional | 62 · Two surgeons | $3,162.28 | $3,630.78 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $6,165.95 Median $6,918.31 Typical High $7,413.10 | Professional | 63 · Small infant | $6,165.95 | $6,918.31 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $4,073.80 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $3,548.13 | $4,073.80 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $812.83 Median $933.25 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $812.83 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $812.83 Median $933.25 Typical High $1,000.00 | Professional | 81 · Minimal assistant surgeon | $812.83 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $812.83 Median $933.25 Typical High $1,000.00 | Professional | 82 · Assistant surgeon, no resident | $812.83 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $691.83 Median $794.33 Typical High $851.14 | Professional | AS · PA/NP assist | $691.83 | $794.33 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,041.74 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $2,041.74 | $3,311.31 | $3,311.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $812.83 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $3,090.30 | $4,897.79 | $4,897.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $616.60 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $407.38 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,884.03 | $4,570.88 | $4,570.88 |
Where Idaho sits
The same service costs 20.4 times more in Alaska than in Texas. 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· 10th of 51
$5,754
AK $13,183TX $646
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.