How much rates vary
Facilitymedian $891 · 10th to 90th $550 to $4,169Professionalmedian $1,862 · 10th to 90th $1,122 to $2,884
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 $1,122.02 Median $2,884.03 Typical High $2,884.03 | Professional | None | $1,122.02 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $4,570.88 | Facility | None | $3,548.13 | $3,801.89 | $4,570.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,995.26 | $2,089.30 |
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 $1,174.90 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,445.44 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,884.03 Typical High $5,495.41 | Facility | None | $891.25 | $2,884.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,905.46 | $2,884.03 |
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 $1,513.56 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,513.56 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,862.09 | $1,862.09 | $1,905.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,995.26 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $954.99 | Facility | None | $891.25 | $891.25 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,862.09 | Professional | None | $891.25 | $891.25 | $1,862.09 |
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 $1,071.52 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,380.38 | $2,137.96 |
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 $562.34 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $562.34 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $223.87 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $851.14 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $169.82 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $112.20 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $794.33 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,737.80 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,548.82 | $1,737.80 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $208.93 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 62 · Two surgeons | $1,071.52 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,041.74 Median $2,290.87 Typical High $2,511.89 | Professional | 63 · Small infant | $2,041.74 | $2,290.87 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 80 · Assistant surgeon | $275.42 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $275.42 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $263.03 Typical High $281.84 | Professional | AS · PA/NP assist | $234.42 | $263.03 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $707.95 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $281.84 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,071.52 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $213.80 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $141.25 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,000.00 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 22 · Increased work | $2,089.30 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 62 · Two surgeons | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 63 · Small infant | $2,089.30 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,445.44 |
Where Idaho sits
The same service costs 4.9 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
$1,862
AK $3,548TX $724
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.