How much rates vary
Facilitymedian $2,042 · 10th to 90th $550 to $9,772Professionalmedian $4,266 · 10th to 90th $2,692 to $7,079
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 $2,398.83 Median $7,079.46 Typical High $7,079.46 | Professional | None | $2,398.83 | $7,079.46 | $7,079.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $11,220.18 | Facility | None | $8,709.64 | $9,332.54 | $11,220.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $4,897.79 | Professional | None | $3,981.07 | $4,677.35 | $4,897.79 |
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 $2,951.21 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,467.37 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $10,000.00 | Facility | None | $2,041.74 | $5,495.41 | $10,000.00 |
Moda Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,570.88 Typical High $7,079.46 | Professional | None | $2,884.03 | $4,570.88 | $7,079.46 |
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 $3,467.37 Median $4,265.80 Typical High $4,265.80 | Facility | None | $3,467.37 | $4,265.80 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,677.35 | Professional | None | $4,265.80 | $4,265.80 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,168.69 | $4,897.79 | $4,897.79 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,238.72 | Facility | None | $2,041.74 | $2,041.74 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $4,466.84 | Professional | None | $2,041.74 | $2,041.74 | $4,466.84 |
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 $2,630.27 Median $3,467.37 Typical High $5,248.07 | Professional | None | $2,630.27 | $3,467.37 | $5,248.07 |
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 $1,380.38 Median $3,548.13 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,380.38 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $562.34 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,089.30 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $416.87 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $707.95 Typical High $707.95 | Professional | 56 · Pre-op care only | $275.42 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $1,949.84 | $4,897.79 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $4,073.80 Typical High $4,365.16 | Professional | 54 · Surgery only | $3,548.13 | $4,073.80 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $457.09 Typical High $478.63 | Professional | 55 · Aftercare only | $398.11 | $457.09 | $478.63 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,454.71 Median $2,884.03 Typical High $3,019.95 | Professional | 62 · Two surgeons | $2,454.71 | $2,884.03 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,786.30 Median $5,495.41 Typical High $5,754.40 | Professional | 63 · Small infant | $4,786.30 | $5,495.41 | $5,754.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,235.94 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,235.94 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $630.96 Median $724.44 Typical High $776.25 | Professional | 80 · Assistant surgeon | $630.96 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $630.96 Median $724.44 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $630.96 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $630.96 Median $724.44 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $630.96 | $724.44 | $776.25 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | AS · PA/NP assist | $537.03 | $616.60 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $3,548.13 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,659.59 | $3,548.13 | $3,548.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $660.69 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,511.89 | $5,248.07 | $5,248.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $501.19 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $707.95 Typical High $707.95 | Professional | 56 · Pre-op care only | $331.13 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $2,344.23 | $4,897.79 | $4,897.79 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | 22 · Increased work | $5,128.61 | $5,128.61 | $5,128.61 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $3,235.94 | $3,235.94 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $467.74 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 62 · Two surgeons | $2,951.21 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | 63 · Small infant | $5,128.61 | $5,128.61 | $5,128.61 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,467.37 | $3,467.37 | $3,467.37 |
Where Idaho sits
The same service costs 21.4 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· 10th of 51
$4,266
AK $8,318TX $389
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.