How much rates vary
Facilitymedian $1,514 · 10th to 90th $550 to $7,244Professionalmedian $3,311 · 10th to 90th $1,995 to $5,129
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 $1,905.46 Median $5,128.61 Typical High $5,128.61 | Professional | None | $1,905.46 | $5,128.61 | $5,128.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,456.54 Median $6,918.31 Typical High $8,317.64 | Facility | None | $6,456.54 | $6,918.31 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $3,630.78 | Professional | None | $2,951.21 | $3,467.37 | $3,630.78 |
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 $2,137.96 Median $2,570.40 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,570.40 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $5,128.61 Typical High $7,413.10 | Facility | None | $1,513.56 | $5,128.61 | $7,413.10 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,454.71 | $3,388.44 | $5,128.61 |
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 $2,570.40 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,570.40 | $3,162.28 | $3,162.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,467.37 | Professional | None | $3,162.28 | $3,162.28 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,090.30 | $3,630.78 | $3,630.78 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,621.81 | Facility | None | $1,513.56 | $1,513.56 | $1,621.81 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,513.56 | $3,311.31 |
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 $1,949.84 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,454.71 | $3,801.89 |
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 $954.99 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $954.99 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $380.19 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,445.44 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $288.40 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $190.55 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,348.96 | $3,630.78 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $3,019.95 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,630.27 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | 55 · Aftercare only | $295.12 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $2,137.96 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,819.70 | $2,137.96 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,548.13 Median $4,073.80 Typical High $4,265.80 | Professional | 63 · Small infant | $3,548.13 | $4,073.80 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,344.23 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 80 · Assistant surgeon | $467.74 | $537.03 | $575.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $467.74 | $537.03 | $575.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $467.74 | $537.03 | $575.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | AS · PA/NP assist | $398.11 | $457.09 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $1,230.27 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $489.78 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,819.70 | $3,890.45 | $3,890.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $363.08 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $245.47 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,698.24 | $3,630.78 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 22 · Increased work | $3,801.89 | $3,801.89 | $3,801.89 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $346.74 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 62 · Two surgeons | $2,137.96 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 63 · Small infant | $3,801.89 | $3,801.89 | $3,801.89 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,570.40 | $2,570.40 |
Where Idaho sits
The same service costs 5.4 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
$3,162
AK $6,310TX $1,175
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.