How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,630 to $10,233Professionalmedian $3,236 · 10th to 90th $2,089 to $3,715
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,187.76 | $3,388.44 | $3,388.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $7,762.47 Typical High $10,964.78 | Facility | None | $4,073.80 | $7,762.47 | $10,964.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $3,630.78 | Professional | None | $3,019.95 | $3,548.13 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,290.87 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,548.82 | $3,388.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $4,073.80 | Professional | None | $2,187.76 | $3,388.44 | $4,073.80 |
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 $2,630.27 Median $3,235.94 Typical High $3,235.94 | Facility | None | $2,630.27 | $3,235.94 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,073.80 | Professional | None | $3,235.94 | $3,235.94 | $4,073.80 |
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 $3,019.95 Median $3,548.13 Typical High $4,073.80 | Professional | None | $3,019.95 | $3,548.13 | $4,073.80 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $9,332.54 | Facility | None | $1,548.82 | $1,584.89 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $4,168.69 | Professional | None | $1,548.82 | $1,698.24 | $4,168.69 |
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 $1,659.59 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,344.23 | $3,467.37 |
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 $1,096.48 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,096.48 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $436.52 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,621.81 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $331.13 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $218.78 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,019.95 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,691.53 | $3,019.95 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,089.30 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,862.09 | $2,089.30 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,630.78 Median $4,073.80 Typical High $4,365.16 | Professional | 63 · Small infant | $3,630.78 | $4,073.80 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,344.23 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,344.23 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 80 · Assistant surgeon | $478.63 | $537.03 | $588.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $478.63 | $537.03 | $588.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $537.03 | $588.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | AS · PA/NP assist | $407.38 | $457.09 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,096.48 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $436.52 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,621.81 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $331.13 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $218.78 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,398.83 | $2,398.83 |
Where Idaho sits
The same service costs 11.2 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· 9th of 51
$3,388
AK $7,244TX $646
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.