How much rates vary
Facilitymedian $955 · 10th to 90th $550 to $3,981Professionalmedian $1,047 · 10th to 90th $617 to $1,622
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 $630.96 Median $1,621.81 Typical High $1,621.81 | Professional | None | $630.96 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $4,570.88 | Facility | None | $645.65 | $2,089.30 | $4,570.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,148.15 | Professional | None | $954.99 | $1,122.02 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $933.25 | Professional | None | $660.69 | $776.25 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $4,466.84 | Facility | None | $501.19 | $1,621.81 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $776.25 | $1,071.52 | $1,621.81 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,047.13 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | None | $977.24 | $1,148.15 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $2,089.30 | Facility | None | $501.19 | $512.86 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,047.13 | Professional | None | $501.19 | $501.19 | $1,047.13 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,174.90 | Professional | None | $588.84 | $758.58 | $1,174.90 |
27 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 $309.03 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $309.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $125.89 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $467.74 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $93.33 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $63.10 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $436.52 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $117.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $676.08 Typical High $724.44 | Professional | 62 · Two surgeons | $602.56 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,148.15 Median $1,288.25 Typical High $1,412.54 | Professional | 63 · Small infant | $1,148.15 | $1,288.25 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 80 · Assistant surgeon | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | AS · PA/NP assist | $131.83 | $147.91 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $389.05 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $154.88 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $575.44 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $117.49 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $77.62 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $537.03 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 22 · Increased work | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 62 · Two surgeons | $676.08 | $676.08 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 63 · Small infant | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Idaho sits
The same service costs 5.5 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· 9th of 51
$1,047
AK $2,188TX $398
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.