How much rates vary
Facilitymedian $1,413 · 10th to 90th $550 to $6,761Professionalmedian $3,020 · 10th to 90th $1,905 to $4,898
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 $1,778.28 Median $4,897.79 Typical High $4,897.79 | Professional | None | $1,778.28 | $4,897.79 | $4,897.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,165.95 Median $6,456.54 Typical High $7,762.47 | Facility | None | $6,165.95 | $6,456.54 | $7,762.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,754.23 | $3,235.94 | $3,388.44 |
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 $2,041.74 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,398.83 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $4,897.79 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,897.79 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,162.28 | $4,897.79 |
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 $2,454.71 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,454.71 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,235.94 | Professional | None | $2,951.21 | $2,951.21 | $3,235.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,884.03 | $3,388.44 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Facility | None | $1,412.54 | $1,412.54 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,412.54 | $3,162.28 |
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 $1,862.09 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,398.83 | $3,630.78 |
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 $891.25 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $891.25 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $363.08 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,348.96 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $269.15 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $181.97 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,258.93 | $3,467.37 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,884.03 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,454.71 | $2,884.03 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $275.42 | $316.23 | $331.13 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $1,995.26 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,737.80 | $1,995.26 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,801.89 Typical High $3,981.07 | Professional | 63 · Small infant | $3,311.31 | $3,801.89 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,238.72 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,238.72 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $512.86 Typical High $537.03 | Professional | 80 · Assistant surgeon | $436.52 | $512.86 | $537.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $436.52 Median $512.86 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $436.52 | $512.86 | $537.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $512.86 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $512.86 | $537.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $436.52 Typical High $457.09 | Professional | AS · PA/NP assist | $371.54 | $436.52 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,148.15 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $457.09 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,737.80 | $3,715.35 | $3,715.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $346.74 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $229.09 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,621.81 | $3,467.37 | $3,467.37 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 22 · Increased work | $3,548.13 | $3,548.13 | $3,548.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 62 · Two surgeons | $2,041.74 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 63 · Small infant | $3,548.13 | $3,548.13 | $3,548.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,454.71 |
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
$3,020
AK $5,888TX $1,096
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.