How much rates vary
Facilitymedian $2,239 · 10th to 90th $550 to $18,197Professionalmedian $8,128 · 10th to 90th $5,129 to $12,882
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 $4,786.30 Median $12,882.50 Typical High $12,882.50 | Professional | None | $4,786.30 | $12,882.50 | $12,882.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $16,218.10 Median $18,197.01 Typical High $21,877.62 | Facility | None | $16,218.10 | $18,197.01 | $21,877.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $7,244.36 Median $8,317.64 Typical High $8,912.51 | Professional | None | $7,244.36 | $8,317.64 | $8,912.51 |
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 $5,370.32 Median $6,309.57 Typical High $7,413.10 | Professional | None | $5,370.32 | $6,309.57 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $2,238.72 Median $5,888.44 Typical High $18,197.01 | Facility | None | $2,238.72 | $5,888.44 | $18,197.01 |
Moda Health Setting Professional Modifier None Typical Low $5,888.44 Median $8,317.64 Typical High $12,882.50 | Professional | None | $5,888.44 | $8,317.64 | $12,882.50 |
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 $6,456.54 Median $7,943.28 Typical High $7,943.28 | Facility | None | $6,456.54 | $7,943.28 | $7,943.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,317.64 | Professional | None | $7,943.28 | $7,943.28 | $8,317.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $8,912.51 | Professional | None | $7,585.78 | $8,912.51 | $8,912.51 |
Select Health Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,073.80 | Facility | None | $3,715.35 | $3,715.35 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $8,128.31 | Professional | None | $3,715.35 | $3,715.35 | $8,128.31 |
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 $4,897.79 Median $6,309.57 Typical High $9,772.37 | Professional | None | $4,897.79 | $6,309.57 | $9,772.37 |
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 $2,511.89 Median $6,309.57 Typical High $6,309.57 | Professional | 52 · Reduced service | $2,511.89 | $6,309.57 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $2,570.40 Typical High $2,570.40 | Professional | 53 · Discontinued | $1,023.29 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $9,549.93 Typical High $9,549.93 | Professional | 54 · Surgery only | $3,801.89 | $9,549.93 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $1,905.46 Typical High $1,905.46 | Professional | 55 · Aftercare only | $758.58 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $1,288.25 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $512.86 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $8,912.51 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $3,548.13 | $8,912.51 | $8,912.51 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $6,606.93 Median $7,585.78 Typical High $7,943.28 | Professional | 54 · Surgery only | $6,606.93 | $7,585.78 | $7,943.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | 55 · Aftercare only | $724.44 | $831.76 | $891.25 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $4,570.88 Median $5,248.07 Typical High $5,495.41 | Professional | 62 · Two surgeons | $4,570.88 | $5,248.07 | $5,495.41 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $8,709.64 Median $10,000.00 Typical High $10,471.29 | Professional | 63 · Small infant | $8,709.64 | $10,000.00 | $10,471.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,128.61 Median $5,888.44 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $5,128.61 | $5,888.44 | $6,165.95 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $1,174.90 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | 81 · Minimal assistant surgeon | $1,174.90 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | 82 · Assistant surgeon, no resident | $1,174.90 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $977.24 Median $1,148.15 Typical High $1,202.26 | Professional | AS · PA/NP assist | $977.24 | $1,148.15 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,951.21 Median $6,309.57 Typical High $6,309.57 | Professional | 52 · Reduced service | $2,951.21 | $6,309.57 | $6,309.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $2,570.40 Typical High $2,570.40 | Professional | 53 · Discontinued | $1,174.90 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $9,549.93 Typical High $9,549.93 | Professional | 54 · Surgery only | $4,466.84 | $9,549.93 | $9,549.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $891.25 Median $1,905.46 Typical High $1,905.46 | Professional | 55 · Aftercare only | $891.25 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $1,288.25 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $588.84 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,168.69 Median $8,912.51 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $4,168.69 | $8,912.51 | $8,912.51 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | 22 · Increased work | $9,332.54 | $9,332.54 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $5,888.44 | $5,888.44 | $5,888.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 56 · Pre-op care only | $831.76 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | 62 · Two surgeons | $5,248.07 | $5,248.07 | $5,248.07 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | 63 · Small infant | $9,332.54 | $9,332.54 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $6,309.57 | $6,309.57 | $6,309.57 |
Where Idaho sits
The same service costs 21.9 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· 10th of 51
$7,943
AK $15,136TX $692
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.