How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,445 to $16,982Professionalmedian $1,445 · 10th to 90th $1,023 to $1,778
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 $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $18,620.87 | Facility | None | $2,398.83 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,548.82 | $1,621.81 |
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 $954.99 Median $1,096.48 Typical High $1,258.93 | Professional | None | $954.99 | $1,096.48 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $5,495.41 | Facility | None | $870.96 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,621.81 | $1,905.46 |
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 $1,174.90 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,445.44 | $1,819.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,621.81 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $6,918.31 | Facility | None | $676.08 | $691.83 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $4,168.69 | Professional | None | $676.08 | $794.33 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,698.24 | Professional | None | $831.76 | $1,148.15 | $1,698.24 |
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 $512.86 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $512.86 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $102.33 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $3,548.13 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | 50 · Both sides | $1,995.26 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $933.25 Typical High $1,000.00 | Professional | 62 · Two surgeons | $831.76 | $933.25 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 63 · Small infant | $1,584.89 | $1,778.28 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 80 · Assistant surgeon | $213.80 | $234.42 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $213.80 | $234.42 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $234.42 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $199.53 Typical High $218.78 | Professional | AS · PA/NP assist | $181.97 | $199.53 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $512.86 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $204.17 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $102.33 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 7.4 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
$1,514
AK $3,311TX $447
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.