How much rates vary
Facilitymedian $9,120 · 10th to 90th $2,239 to $26,303Professionalmedian $2,884 · 10th to 90th $1,995 to $3,548
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,041.74 | $3,311.31 | $3,311.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $8,128.31 Typical High $30,902.95 | Facility | None | $5,888.44 | $8,128.31 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,235.94 | Professional | None | $2,570.40 | $3,019.95 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $10,232.93 Median $11,481.54 Typical High $15,488.17 | Facility | None | $10,232.93 | $11,481.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,949.84 | $2,238.72 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,348.96 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,041.74 | $3,311.31 | $3,890.45 |
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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,818.38 | $2,818.38 | $3,548.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,054.61 Median $25,118.86 Typical High $31,622.78 | Facility | None | $19,054.61 | $25,118.86 | $31,622.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,235.94 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,412.54 | Facility | None | $1,348.96 | $1,348.96 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $10,471.29 | Professional | None | $1,348.96 | $1,621.81 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,344.23 | $3,467.37 |
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 $1,023.29 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,023.29 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $407.38 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,548.82 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $309.03 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $204.17 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,630.27 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,344.23 | $2,630.27 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $316.23 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $316.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,819.70 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,621.81 | $1,819.70 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,090.30 Median $3,467.37 Typical High $3,801.89 | Professional | 63 · Small infant | $3,090.30 | $3,467.37 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,041.74 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 80 · Assistant surgeon | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $416.87 | $467.74 | $501.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $398.11 Typical High $426.58 | Professional | AS · PA/NP assist | $354.81 | $398.11 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,023.29 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $407.38 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,548.82 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $309.03 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $204.17 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,290.87 | $2,290.87 |
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
$2,884
AK $6,607TX $324
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.