How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $3,802Professionalmedian $1,479 · 10th to 90th $912 to $1,950
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 $912.01 Median $1,949.84 Typical High $1,949.84 | Professional | None | $912.01 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $3,801.89 | Facility | None | $2,951.21 | $3,162.28 | $3,801.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,621.81 | $1,698.24 |
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 $1,000.00 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,148.15 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $1,949.84 Typical High $5,495.41 | Facility | None | $724.44 | $1,949.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,513.56 | $1,949.84 |
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,230.27 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,479.11 | $1,513.56 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,621.81 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $776.25 | Facility | None | $724.44 | $724.44 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | None | $724.44 | $724.44 | $1,000.00 |
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 $812.83 Median $1,202.26 Typical High $1,737.80 | Professional | None | $812.83 | $1,202.26 | $1,737.80 |
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 $457.09 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $457.09 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $181.97 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $691.83 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $138.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $91.20 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $645.65 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $169.82 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $933.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $851.14 | $933.25 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,621.81 Median $1,778.28 Typical High $2,041.74 | Professional | 63 · Small infant | $1,621.81 | $1,778.28 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 80 · Assistant surgeon | $218.78 | $234.42 | $269.15 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $218.78 | $234.42 | $269.15 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $234.42 | $269.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | AS · PA/NP assist | $181.97 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $549.54 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $218.78 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $812.83 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $162.18 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $109.65 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $758.58 | $1,348.96 | $1,348.96 |
Where Idaho sits
The same service costs 6.2 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· 13th of 51
$1,445
AK $3,311TX $537
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.