How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,072 to $5,248Professionalmedian $2,291 · 10th to 90th $1,413 to $3,715
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 $1,348.96 Median $3,715.35 Typical High $3,715.35 | Professional | None | $1,348.96 | $3,715.35 | $3,715.35 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $5,888.44 | Facility | None | $4,570.88 | $4,897.79 | $5,888.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,454.71 | $2,570.40 |
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 $1,513.56 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,819.70 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $3,715.35 Typical High $5,495.41 | Facility | None | $1,071.52 | $3,715.35 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,398.83 | $3,715.35 |
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 $1,862.09 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,862.09 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,454.71 | Professional | None | $2,290.87 | $2,290.87 | $2,454.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,570.40 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Facility | None | $1,071.52 | $1,071.52 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,071.52 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,778.28 | $2,691.53 |
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 $676.08 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $676.08 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $269.15 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,023.29 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $204.17 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $134.90 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $954.99 | $2,570.40 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,187.76 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,905.46 | $2,187.76 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,513.56 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,318.26 | $1,513.56 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 63 · Small infant | $2,511.89 | $2,884.03 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 80 · Assistant surgeon | $338.84 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $338.84 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $331.13 Typical High $346.74 | Professional | AS · PA/NP assist | $288.40 | $331.13 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $870.96 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $346.74 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,318.26 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $263.03 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $173.78 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,230.27 | $2,570.40 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 22 · Increased work | $2,691.53 | $2,691.53 | $2,691.53 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,513.56 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 63 · Small infant | $2,691.53 | $2,691.53 | $2,691.53 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,819.70 |
Where Idaho sits
The same service costs 26.3 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· 11th of 51
$2,291
AK $5,248TX $200
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.