How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,399 to $10,965Professionalmedian $2,754 · 10th to 90th $1,950 to $3,467
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 $1,778.28 Median $3,235.94 Typical High $3,235.94 | Professional | None | $1,778.28 | $3,235.94 | $3,235.94 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $12,022.64 | Facility | None | $5,754.40 | $7,413.10 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $3,162.28 | Professional | None | $2,511.89 | $2,951.21 | $3,162.28 |
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 $1,905.46 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,187.76 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,479.11 Median $3,235.94 Typical High $5,495.41 | Facility | None | $1,479.11 | $3,235.94 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $3,715.35 | Professional | None | $1,995.26 | $3,235.94 | $3,715.35 |
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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,238.72 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,754.23 | $2,754.23 | $3,467.37 |
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 $2,691.53 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,691.53 | $3,162.28 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Facility | None | $1,288.25 | $1,288.25 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $5,248.07 | Professional | None | $1,288.25 | $1,584.89 | $5,248.07 |
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 $2,290.87 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,290.87 | $3,388.44 |
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 $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,000.00 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $398.11 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,513.56 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $302.00 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $199.53 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,238.72 | $2,238.72 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $11,220.18 Typical High $18,197.01 | Facility | 50 · Both sides | $8,709.64 | $11,220.18 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,801.89 Median $4,265.80 Typical High $4,570.88 | Professional | 50 · Both sides | $3,801.89 | $4,265.80 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,570.40 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,290.87 | $2,570.40 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $281.84 | $309.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $1,778.28 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,584.89 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,019.95 Median $3,388.44 Typical High $3,715.35 | Professional | 63 · Small infant | $3,019.95 | $3,388.44 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,995.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,995.26 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $457.09 Typical High $489.78 | Professional | 80 · Assistant surgeon | $407.38 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $457.09 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $407.38 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $457.09 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | AS · PA/NP assist | $346.74 | $380.19 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,000.00 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $398.11 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,513.56 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $302.00 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $199.53 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,238.72 | $2,238.72 |
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· 11th of 51
$2,818
AK $6,457TX $724
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.