How much rates vary
Facilitymedian $6,310 · 10th to 90th $2,089 to $14,125Professionalmedian $2,884 · 10th to 90th $1,995 to $3,467
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,089.30 | $3,235.94 | $3,235.94 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $6,918.31 Typical High $15,135.61 | Facility | None | $3,388.44 | $6,918.31 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,090.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,238.72 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,235.94 Typical High $5,495.41 | Facility | None | $1,445.44 | $3,235.94 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $3,801.89 | Professional | None | $2,089.30 | $3,235.94 | $3,801.89 |
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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,818.38 | $2,818.38 | $3,548.13 |
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 $2,884.03 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,884.03 | $3,162.28 | $3,801.89 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $10,471.29 | Facility | None | $1,348.96 | $1,380.38 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $5,754.40 | Professional | None | $1,348.96 | $1,584.89 | $5,754.40 |
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 $1,659.59 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,344.23 | $3,467.37 |
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 $1,047.13 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,047.13 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $416.87 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,584.89 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $316.23 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $208.93 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $10,232.93 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $10,232.93 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,890.45 Median $4,365.16 Typical High $4,786.30 | Professional | 50 · Both sides | $3,890.45 | $4,365.16 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,630.27 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,344.23 | $2,630.27 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $316.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,819.70 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,621.81 | $1,819.70 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,162.28 Median $3,467.37 Typical High $3,801.89 | Professional | 63 · Small infant | $3,162.28 | $3,467.37 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,041.74 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,041.74 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 80 · Assistant surgeon | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $398.11 Typical High $426.58 | Professional | AS · PA/NP assist | $354.81 | $398.11 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,047.13 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $416.87 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,584.89 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $316.23 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $208.93 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,290.87 | $2,290.87 |
Where Idaho sits
The same service costs 20.0 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
$2,884
AK $6,457TX $324
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.