How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $13,804Professionalmedian $6,166 · 10th to 90th $3,890 to $8,318
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 $3,981.07 Median $8,317.64 Typical High $8,317.64 | Professional | None | $3,981.07 | $8,317.64 | $8,317.64 |
BCBS Idaho Setting Facility Modifier None Typical Low $12,882.50 Median $13,489.63 Typical High $16,595.87 | Facility | None | $12,882.50 | $13,489.63 | $16,595.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $5,754.40 Median $6,760.83 Typical High $6,918.31 | Professional | None | $5,754.40 | $6,760.83 | $6,918.31 |
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 $4,265.80 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,265.80 | $4,897.79 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $1,819.70 Median $5,495.41 Typical High $12,022.64 | Facility | None | $1,819.70 | $5,495.41 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $8,317.64 | Professional | None | $4,677.35 | $6,456.54 | $8,317.64 |
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 $5,011.87 Median $6,165.95 Typical High $6,165.95 | Facility | None | $5,011.87 | $6,165.95 | $6,165.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,309.57 | Professional | None | $6,165.95 | $6,165.95 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,025.60 Median $6,918.31 Typical High $7,079.46 | Professional | None | $6,025.60 | $6,918.31 | $7,079.46 |
Select Health Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,235.94 | Facility | None | $2,951.21 | $2,951.21 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,951.21 | $2,951.21 | $4,265.80 |
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 $3,090.30 Median $5,128.61 Typical High $7,585.78 | Professional | None | $3,090.30 | $5,128.61 | $7,585.78 |
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 $1,995.26 Median $4,168.69 Typical High $4,168.69 | Professional | 52 · Reduced service | $1,995.26 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,659.59 Typical High $1,659.59 | Professional | 53 · Discontinued | $794.33 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $6,309.57 Typical High $6,309.57 | Professional | 54 · Surgery only | $2,951.21 | $6,309.57 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $1,258.93 Typical High $1,258.93 | Professional | 55 · Aftercare only | $588.84 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $831.76 Typical High $831.76 | Professional | 56 · Pre-op care only | $398.11 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $5,888.44 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $2,754.23 | $5,888.44 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $5,011.87 Median $5,623.41 Typical High $6,309.57 | Professional | 54 · Surgery only | $5,011.87 | $5,623.41 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $630.96 Typical High $691.83 | Professional | 55 · Aftercare only | $562.34 | $630.96 | $691.83 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,467.37 Median $3,981.07 Typical High $4,365.16 | Professional | 62 · Two surgeons | $3,467.37 | $3,981.07 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $6,760.83 Median $7,585.78 Typical High $8,317.64 | Professional | 63 · Small infant | $6,760.83 | $7,585.78 | $8,317.64 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,890.45 Median $4,365.16 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $3,890.45 | $4,365.16 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $891.25 Median $1,000.00 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $891.25 | $1,000.00 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $891.25 Median $1,000.00 Typical High $1,122.02 | Professional | 81 · Minimal assistant surgeon | $891.25 | $1,000.00 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $891.25 Median $1,000.00 Typical High $1,122.02 | Professional | 82 · Assistant surgeon, no resident | $891.25 | $1,000.00 | $1,122.02 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $758.58 Median $851.14 Typical High $954.99 | Professional | AS · PA/NP assist | $758.58 | $851.14 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,290.87 Median $4,168.69 Typical High $4,168.69 | Professional | 52 · Reduced service | $2,290.87 | $4,168.69 | $4,168.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,659.59 Typical High $1,659.59 | Professional | 53 · Discontinued | $933.25 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $6,309.57 Typical High $6,309.57 | Professional | 54 · Surgery only | $3,467.37 | $6,309.57 | $6,309.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $1,258.93 Typical High $1,258.93 | Professional | 55 · Aftercare only | $691.83 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $831.76 Typical High $831.76 | Professional | 56 · Pre-op care only | $467.74 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $5,888.44 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $3,235.94 | $5,888.44 | $5,888.44 |
Where Idaho sits
The same service costs 10.7 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
$5,888
AK $14,125TX $1,318
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.