How much rates vary
Facilitymedian $5,888 · 10th to 90th $2,138 to $12,589Professionalmedian $6,607 · 10th to 90th $4,571 to $8,318
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $7,762.47 | Professional | None | $4,570.88 | $7,762.47 | $7,762.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,918.31 Median $11,748.98 Typical High $13,489.63 | Facility | None | $6,918.31 | $11,748.98 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $6,025.60 Median $7,079.46 Typical High $7,585.78 | Professional | None | $6,025.60 | $7,079.46 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $6,025.60 | Professional | None | $4,265.80 | $5,248.07 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $3,388.44 Median $5,495.41 Typical High $8,709.64 | Facility | None | $3,388.44 | $5,495.41 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $4,897.79 Median $7,762.47 Typical High $9,120.11 | Professional | None | $4,897.79 | $7,762.47 | $9,120.11 |
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 $5,370.32 Median $6,606.93 Typical High $6,606.93 | Facility | None | $5,370.32 | $6,606.93 | $6,606.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,317.64 | Professional | None | $6,606.93 | $6,606.93 | $8,317.64 |
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 $6,456.54 Median $7,585.78 Typical High $9,120.11 | Professional | None | $6,456.54 | $7,585.78 | $9,120.11 |
Select Health Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,090.30 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $5,754.40 | Professional | None | $3,090.30 | $3,801.89 | $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 $3,630.78 Median $5,128.61 Typical High $7,413.10 | Professional | None | $3,630.78 | $5,128.61 | $7,413.10 |
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 $2,454.71 Median $3,890.45 Typical High $3,890.45 | Professional | 52 · Reduced service | $2,454.71 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,548.82 Typical High $1,548.82 | Professional | 53 · Discontinued | $977.24 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $3,630.78 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $1,174.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $724.44 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 56 · Pre-op care only | $489.78 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $3,388.44 | $5,495.41 | $5,495.41 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $9,772.37 Median $16,595.87 Typical High $20,417.38 | Facility | 50 · Both sides | $9,772.37 | $16,595.87 | $20,417.38 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $9,120.11 Median $10,232.93 Typical High $10,964.78 | Professional | 50 · Both sides | $9,120.11 | $10,232.93 | $10,964.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $5,495.41 Median $6,165.95 Typical High $6,606.93 | Professional | 54 · Surgery only | $5,495.41 | $6,165.95 | $6,606.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $676.08 Typical High $741.31 | Professional | 55 · Aftercare only | $602.56 | $676.08 | $741.31 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,801.89 Median $4,265.80 Typical High $4,570.88 | Professional | 62 · Two surgeons | $3,801.89 | $4,265.80 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $7,244.36 Median $8,128.31 Typical High $8,912.51 | Professional | 63 · Small infant | $7,244.36 | $8,128.31 | $8,912.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,265.80 Median $4,786.30 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $4,265.80 | $4,786.30 | $5,128.61 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $977.24 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 81 · Minimal assistant surgeon | $977.24 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 82 · Assistant surgeon, no resident | $977.24 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $831.76 Median $933.25 Typical High $1,000.00 | Professional | AS · PA/NP assist | $831.76 | $933.25 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,454.71 Median $3,890.45 Typical High $3,890.45 | Professional | 52 · Reduced service | $2,454.71 | $3,890.45 | $3,890.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,548.82 Typical High $1,548.82 | Professional | 53 · Discontinued | $977.24 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $3,630.78 | $5,888.44 | $5,888.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $1,174.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $724.44 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 56 · Pre-op care only | $489.78 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $3,388.44 | $5,495.41 | $5,495.41 |
Where Idaho sits
The same service costs 20.4 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
$6,607
AK $15,488TX $759
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.