How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,514 to $17,378Professionalmedian $2,630 · 10th to 90th $1,820 to $3,236
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 $1,862.09 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,951.21 | $2,951.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,570.40 Median $8,709.64 Typical High $21,877.62 | Facility | None | $2,570.40 | $8,709.64 | $21,877.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,754.23 | $2,951.21 |
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 $1,621.81 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,621.81 | $2,041.74 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $5,495.41 | Facility | None | $1,202.26 | $2,951.21 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,951.21 | $3,467.37 |
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 $2,089.30 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,089.30 | $2,511.89 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,235.94 | Professional | None | $2,511.89 | $2,511.89 | $3,235.94 |
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 $2,630.27 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,630.27 | $2,951.21 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $6,918.31 | Facility | None | $1,202.26 | $1,230.27 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $4,168.69 | Professional | None | $1,202.26 | $1,445.44 | $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 $1,513.56 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,137.96 | $3,162.28 |
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 $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,380.38 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $281.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $186.21 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,089.30 | $2,089.30 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,715.35 Median $13,182.57 Typical High $32,359.37 | Facility | 50 · Both sides | $3,715.35 | $13,182.57 | $32,359.37 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,548.13 Median $3,981.07 Typical High $4,265.80 | Professional | 50 · Both sides | $3,548.13 | $3,981.07 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,344.23 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,137.96 | $2,344.23 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $263.03 | $288.40 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,659.59 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,479.11 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,818.38 Median $3,162.28 Typical High $3,388.44 | Professional | 63 · Small infant | $2,818.38 | $3,162.28 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 80 · Assistant surgeon | $371.54 | $416.87 | $457.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $371.54 | $416.87 | $457.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $416.87 | $457.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | AS · PA/NP assist | $316.23 | $354.81 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $933.25 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $371.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,380.38 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $281.84 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $186.21 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,089.30 | $2,089.30 |
Where Idaho sits
The same service costs 8.9 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· 10th of 51
$2,630
AK $6,026TX $676
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.