How much rates vary
Facilitymedian $15,136 · 10th to 90th $3,802 to $26,303Professionalmedian $6,918 · 10th to 90th $4,898 to $8,318
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 $4,897.79 Median $7,943.28 Typical High $7,943.28 | Professional | None | $4,897.79 | $7,943.28 | $7,943.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $13,182.57 Median $18,197.01 Typical High $30,902.95 | Facility | None | $13,182.57 | $18,197.01 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $6,165.95 Median $7,244.36 Typical High $7,762.47 | Professional | None | $6,165.95 | $7,244.36 | $7,762.47 |
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 $4,677.35 Median $5,370.32 Typical High $6,165.95 | Professional | None | $4,677.35 | $5,370.32 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $3,162.28 Median $5,495.41 Typical High $11,481.54 | Facility | None | $3,162.28 | $5,495.41 | $11,481.54 |
Moda Health Setting Professional Modifier None Typical Low $4,897.79 Median $7,943.28 Typical High $9,332.54 | Professional | None | $4,897.79 | $7,943.28 | $9,332.54 |
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 $5,370.32 Median $6,606.93 Typical High $6,606.93 | Facility | None | $5,370.32 | $6,606.93 | $6,606.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,511.38 | Professional | None | $6,606.93 | $6,606.93 | $8,511.38 |
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 $6,606.93 Median $7,762.47 Typical High $9,332.54 | Professional | None | $6,606.93 | $7,762.47 | $9,332.54 |
Select Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,388.44 | Facility | None | $3,162.28 | $3,162.28 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $15,848.93 | Professional | None | $3,162.28 | $3,890.45 | $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 $4,265.80 Median $5,754.40 Typical High $8,128.31 | Professional | None | $4,265.80 | $5,754.40 | $8,128.31 |
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 $2,454.71 Median $3,981.07 Typical High $3,981.07 | Professional | 52 · Reduced service | $2,454.71 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 53 · Discontinued | $1,000.00 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $6,025.60 Typical High $6,025.60 | Professional | 54 · Surgery only | $3,715.35 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $741.31 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $794.33 Typical High $794.33 | Professional | 56 · Pre-op care only | $489.78 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,467.37 Median $5,623.41 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $3,467.37 | $5,623.41 | $5,623.41 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $14,125.38 Median $28,840.32 Typical High $45,708.82 | Facility | 50 · Both sides | $14,125.38 | $28,840.32 | $45,708.82 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $9,120.11 Median $10,471.29 Typical High $11,220.18 | Professional | 50 · Both sides | $9,120.11 | $10,471.29 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $5,495.41 Median $6,309.57 Typical High $6,760.83 | Professional | 54 · Surgery only | $5,495.41 | $6,309.57 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $691.83 Typical High $741.31 | Professional | 55 · Aftercare only | $616.60 | $691.83 | $741.31 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,801.89 Median $4,365.16 Typical High $4,677.35 | Professional | 62 · Two surgeons | $3,801.89 | $4,365.16 | $4,677.35 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $7,413.10 Median $8,317.64 Typical High $8,912.51 | Professional | 63 · Small infant | $7,413.10 | $8,317.64 | $8,912.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,265.80 Median $4,897.79 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $4,265.80 | $4,897.79 | $5,248.07 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $977.24 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | 81 · Minimal assistant surgeon | $977.24 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | 82 · Assistant surgeon, no resident | $977.24 | $1,122.02 | $1,202.26 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $831.76 Median $954.99 Typical High $1,023.29 | Professional | AS · PA/NP assist | $831.76 | $954.99 | $1,023.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,454.71 Median $3,981.07 Typical High $3,981.07 | Professional | 52 · Reduced service | $2,454.71 | $3,981.07 | $3,981.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 53 · Discontinued | $1,000.00 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $6,025.60 Typical High $6,025.60 | Professional | 54 · Surgery only | $3,715.35 | $6,025.60 | $6,025.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $741.31 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $794.33 Typical High $794.33 | Professional | 56 · Pre-op care only | $489.78 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,467.37 Median $5,623.41 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $3,467.37 | $5,623.41 | $5,623.41 |
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
$6,918
AK $15,849TX $776
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.