How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,950 to $15,136Professionalmedian $2,042 · 10th to 90th $1,514 to $2,512
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,630.78 Median $9,332.54 Typical High $17,782.79 | Facility | None | $3,630.78 | $9,332.54 | $17,782.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,187.76 | $2,290.87 |
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 $1,412.54 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,698.24 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,511.89 Typical High $5,495.41 | Facility | None | $1,412.54 | $2,511.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,511.89 | $2,818.38 |
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 $1,621.81 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,995.26 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,995.26 | $1,995.26 | $2,570.40 |
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 $2,041.74 Median $2,290.87 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,290.87 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $977.24 Typical High $10,471.29 | Facility | None | $954.99 | $977.24 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $3,388.44 | Professional | None | $954.99 | $1,174.90 | $3,388.44 |
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 $1,318.26 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,778.28 | $2,570.40 |
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 $758.58 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $758.58 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $302.00 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,148.15 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $229.09 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $151.36 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,905.46 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,905.46 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,318.26 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,148.15 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,238.72 Median $2,511.89 Typical High $2,691.53 | Professional | 63 · Small infant | $2,238.72 | $2,511.89 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | 80 · Assistant surgeon | $295.12 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $295.12 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $288.40 Typical High $302.00 | Professional | AS · PA/NP assist | $251.19 | $288.40 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $758.58 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $302.00 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,148.15 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $229.09 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $151.36 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 16.6 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· 11th of 51
$2,138
AK $4,677TX $282
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.