How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,445 to $14,125Professionalmedian $1,445 · 10th to 90th $912 to $2,042
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 $933.25 Median $2,041.74 Typical High $2,041.74 | Professional | None | $933.25 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,548.13 | $5,754.40 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,584.89 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,380.38 | Professional | None | $933.25 | $1,230.27 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $5,495.41 | Facility | None | $741.31 | $2,041.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,621.81 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,445.44 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,659.59 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $10,715.19 | Facility | None | $691.83 | $707.95 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,047.13 | Professional | None | $691.83 | $691.83 | $1,047.13 |
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 $776.25 Median $1,148.15 Typical High $1,698.24 | Professional | None | $776.25 | $1,148.15 | $1,698.24 |
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 $467.74 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $467.74 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $186.21 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $691.83 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $138.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $93.33 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $645.65 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $8,511.38 Typical High $22,908.68 | Facility | 50 · Both sides | $5,128.61 | $8,511.38 | $22,908.68 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,344.23 Typical High $2,454.71 | Professional | 50 · Both sides | $1,949.84 | $2,344.23 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,174.90 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $162.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,023.29 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | 63 · Small infant | $1,584.89 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,096.48 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $223.87 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $588.84 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $234.42 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $870.96 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $173.78 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $117.49 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $812.83 | $1,445.44 | $1,445.44 |
Where Idaho sits
The same service costs 7.4 times more in Oklahoma 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
$1,622
OK $3,890TX $525
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.