How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,230 to $13,183Professionalmedian $1,820 · 10th to 90th $1,349 to $2,239
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,174.90 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,019.95 Median $4,677.35 Typical High $15,135.61 | Facility | None | $3,019.95 | $4,677.35 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,949.84 | $1,995.26 |
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 $1,348.96 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,513.56 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,148.15 | $2,137.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $2,454.71 | Professional | None | $1,380.38 | $2,137.96 | $2,454.71 |
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 $1,445.44 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,445.44 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,778.28 | $2,238.72 |
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 $1,905.46 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,905.46 | $1,995.26 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $4,677.35 | Facility | None | $851.14 | $870.96 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $3,388.44 | Professional | None | $851.14 | $1,023.29 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,659.59 | $2,398.83 |
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 $691.83 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $691.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $275.42 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $208.93 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $138.04 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,479.11 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $199.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,148.15 Typical High $1,258.93 | Professional | 62 · Two surgeons | $1,023.29 | $1,148.15 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,949.84 Median $2,187.76 Typical High $2,398.83 | Professional | 63 · Small infant | $1,949.84 | $2,187.76 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,288.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,288.25 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $295.12 Typical High $316.23 | Professional | 80 · Assistant surgeon | $263.03 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $295.12 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $263.03 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $295.12 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | AS · PA/NP assist | $223.87 | $251.19 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $691.83 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $275.42 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $208.93 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $138.04 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 7.9 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
$1,862
AK $4,074TX $513
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.