How much rates vary
Facilitymedian $1,738 · 10th to 90th $550 to $8,511Professionalmedian $3,631 · 10th to 90th $2,344 to $5,129
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 $2,344.23 Median $5,128.61 Typical High $5,128.61 | Professional | None | $2,344.23 | $5,128.61 | $5,128.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,762.47 Median $8,128.31 Typical High $10,000.00 | Facility | None | $7,762.47 | $8,128.31 | $10,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,168.69 | Professional | None | $3,311.31 | $3,890.45 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,630.78 | Professional | None | $2,570.40 | $3,019.95 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $5,128.61 Typical High $7,413.10 | Facility | None | $1,659.59 | $5,128.61 | $7,413.10 |
Moda Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $5,128.61 | Professional | None | $2,951.21 | $3,801.89 | $5,128.61 |
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 $2,951.21 Median $3,630.78 Typical High $3,630.78 | Facility | None | $2,951.21 | $3,630.78 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,890.45 | Professional | None | $3,630.78 | $3,630.78 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,365.16 | Professional | None | $3,548.13 | $4,168.69 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,737.80 | $1,737.80 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,737.80 | $1,737.80 | $2,630.27 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,041.74 | $3,090.30 | $4,466.84 |
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 $1,174.90 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $1,174.90 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $467.74 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,737.80 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $346.74 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $234.42 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,621.81 | $3,630.78 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,467.37 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,951.21 | $3,467.37 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $389.05 Typical High $407.38 | Professional | 55 · Aftercare only | $323.59 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $2,398.83 Typical High $2,511.89 | Professional | 62 · Two surgeons | $2,041.74 | $2,398.83 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,890.45 Median $4,570.88 Typical High $4,897.79 | Professional | 63 · Small infant | $3,890.45 | $4,570.88 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,691.53 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,691.53 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $616.60 Typical High $645.65 | Professional | 80 · Assistant surgeon | $524.81 | $616.60 | $645.65 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $524.81 Median $616.60 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $524.81 | $616.60 | $645.65 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $524.81 Median $616.60 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $524.81 | $616.60 | $645.65 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $524.81 Typical High $549.54 | Professional | AS · PA/NP assist | $446.68 | $524.81 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $1,479.11 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $588.84 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $2,187.76 | $3,890.45 | $3,890.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $436.52 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $295.12 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $2,041.74 | $3,630.78 | $3,630.78 |
Where Idaho sits
The same service costs 22.9 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
$3,631
AK $8,511TX $372
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.