How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,692 to $12,023Professionalmedian $4,677 · 10th to 90th $3,236 to $5,623
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 $3,311.31 Median $5,370.32 Typical High $5,370.32 | Professional | None | $3,311.31 | $5,370.32 | $5,370.32 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,760.83 Median $7,762.47 Typical High $13,489.63 | Facility | None | $6,760.83 | $7,762.47 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $5,248.07 | Professional | None | $4,168.69 | $4,897.79 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,630.78 Typical High $4,073.80 | Professional | None | $3,162.28 | $3,630.78 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $3,019.95 Median $5,370.32 Typical High $7,585.78 | Facility | None | $3,019.95 | $5,370.32 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $6,309.57 | Professional | None | $3,311.31 | $5,370.32 | $6,309.57 |
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 $3,630.78 Median $4,466.84 Typical High $4,466.84 | Facility | None | $3,630.78 | $4,466.84 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,754.40 | Professional | None | $4,466.84 | $4,466.84 | $5,754.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $6,309.57 | Professional | None | $4,466.84 | $5,248.07 | $6,309.57 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $19,498.45 | Facility | None | $2,137.96 | $2,137.96 | $19,498.45 |
Select Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $5,248.07 | Professional | None | $2,137.96 | $2,630.27 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,818.38 | $3,801.89 | $5,623.41 |
21 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 $1,659.59 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,659.59 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $660.69 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,511.89 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $501.19 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $331.13 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,344.23 | $3,715.35 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $4,265.80 Typical High $4,570.88 | Professional | 54 · Surgery only | $3,715.35 | $4,265.80 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 55 · Aftercare only | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | 62 · Two surgeons | $2,570.40 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,011.87 Median $5,623.41 Typical High $6,025.60 | Professional | 63 · Small infant | $5,011.87 | $5,623.41 | $6,025.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,311.31 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 80 · Assistant surgeon | $660.69 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $660.69 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $660.69 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | AS · PA/NP assist | $562.34 | $645.65 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,659.59 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $660.69 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,511.89 | $3,981.07 | $3,981.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $501.19 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $331.13 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,344.23 | $3,715.35 | $3,715.35 |
Where Idaho sits
The same service costs 8.7 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
$4,677
AK $10,715TX $1,230
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.