How much rates vary
Facilitymedian $1,259 · 10th to 90th $550 to $5,888Professionalmedian $2,692 · 10th to 90th $1,622 to $4,169
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 $1,621.81 Median $4,168.69 Typical High $4,168.69 | Professional | None | $1,621.81 | $4,168.69 | $4,168.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,248.07 Median $5,623.41 Typical High $6,760.83 | Facility | None | $5,248.07 | $5,623.41 | $6,760.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,818.38 | $2,951.21 |
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 $1,737.80 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,041.74 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $4,168.69 Typical High $5,888.44 | Facility | None | $1,258.93 | $4,168.69 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $4,168.69 | Professional | None | $1,949.84 | $2,691.53 | $4,168.69 |
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 $2,137.96 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,137.96 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,630.27 | $2,630.27 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,884.03 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Facility | None | $1,258.93 | $1,258.93 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,258.93 | $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 $1,584.89 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,041.74 | $3,090.30 |
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 $812.83 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $812.83 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $331.13 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,230.27 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $245.47 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $162.18 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,148.15 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,454.71 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,187.76 | $2,454.71 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $275.42 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $275.42 | $295.12 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,737.80 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,513.56 | $1,737.80 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,951.21 Median $3,311.31 Typical High $3,548.13 | Professional | 63 · Small infant | $2,951.21 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 80 · Assistant surgeon | $389.05 | $436.52 | $478.63 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $389.05 | $436.52 | $478.63 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $436.52 | $478.63 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | AS · PA/NP assist | $331.13 | $371.54 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $977.24 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $389.05 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,479.11 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $295.12 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $194.98 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,380.38 | $2,884.03 | $2,884.03 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 22 · Increased work | $3,019.95 | $3,019.95 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,737.80 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 63 · Small infant | $3,019.95 | $3,019.95 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $2,041.74 |
Where Idaho sits
The same service costs 5.0 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
$2,692
AK $5,012TX $1,000
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.