How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,514 to $7,762Professionalmedian $1,585 · 10th to 90th $1,047 to $1,862
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 $1,122.02 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,137.96 | $3,467.37 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,698.24 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,318.26 | Professional | None | $933.25 | $1,174.90 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $5,495.41 | Facility | None | $977.24 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,737.80 | $2,041.74 |
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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,698.24 | $2,041.74 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $6,309.57 | Facility | None | $758.58 | $776.25 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,862.09 | Professional | None | $758.58 | $831.76 | $1,862.09 |
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 $851.14 Median $1,174.90 Typical High $1,698.24 | Professional | None | $851.14 | $1,174.90 | $1,698.24 |
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 $562.34 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $562.34 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $223.87 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $831.76 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $112.20 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $177.83 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,023.29 Typical High $1,096.48 | Professional | 62 · Two surgeons | $912.01 | $1,023.29 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,737.80 Median $1,949.84 Typical High $2,137.96 | Professional | 63 · Small infant | $1,737.80 | $1,949.84 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $263.03 Typical High $281.84 | Professional | 80 · Assistant surgeon | $234.42 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $263.03 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $234.42 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $263.03 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | AS · PA/NP assist | $199.53 | $223.87 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $562.34 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $223.87 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $831.76 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $112.20 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $1,230.27 | $1,230.27 |
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· 9th of 51
$1,622
AK $3,467TX $468
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.