How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $10,000Professionalmedian $4,467 · 10th to 90th $2,754 to $7,244
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 $2,818.38 Median $7,244.36 Typical High $7,244.36 | Professional | None | $2,818.38 | $7,244.36 | $7,244.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,511.38 Median $9,332.54 Typical High $13,182.57 | Facility | None | $8,511.38 | $9,332.54 | $13,182.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,168.69 Median $4,786.30 Typical High $5,011.87 | Professional | None | $4,168.69 | $4,786.30 | $5,011.87 |
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 $3,548.13 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,548.13 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,348.96 | $4,466.84 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $3,388.44 Median $4,677.35 Typical High $7,244.36 | Professional | None | $3,388.44 | $4,677.35 | $7,244.36 |
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 $3,630.78 Median $4,466.84 Typical High $4,466.84 | Facility | None | $3,630.78 | $4,466.84 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,466.84 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,265.80 | $5,011.87 | $5,011.87 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,290.87 | Facility | None | $2,137.96 | $2,137.96 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,570.88 | Professional | None | $2,137.96 | $2,137.96 | $4,570.88 |
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 $3,388.44 Typical High $5,128.61 | Professional | None | $2,630.27 | $3,388.44 | $5,128.61 |
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 $1,412.54 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,412.54 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $562.34 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $5,370.32 Typical High $5,370.32 | Professional | 54 · Surgery only | $2,089.30 | $5,370.32 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $426.58 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $281.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $5,011.87 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $1,949.84 | $5,011.87 | $5,011.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $4,265.80 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,715.35 | $4,265.80 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $478.63 Typical High $501.19 | Professional | 55 · Aftercare only | $416.87 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | 62 · Two surgeons | $2,570.40 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,011.87 Median $5,754.40 Typical High $6,025.60 | Professional | 63 · Small infant | $5,011.87 | $5,754.40 | $6,025.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,311.31 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $758.58 Typical High $794.33 | Professional | 80 · Assistant surgeon | $660.69 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $660.69 Median $758.58 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $660.69 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $660.69 Median $758.58 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $660.69 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $645.65 Typical High $676.08 | Professional | AS · PA/NP assist | $562.34 | $645.65 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,698.24 | $3,630.78 | $3,630.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $676.08 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $5,370.32 Typical High $5,370.32 | Professional | 54 · Surgery only | $2,570.40 | $5,370.32 | $5,370.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $512.86 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $338.84 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $5,011.87 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $2,398.83 | $5,011.87 | $5,011.87 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | 22 · Increased work | $5,248.07 | $5,248.07 | $5,248.07 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $478.63 |
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 $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | 63 · Small infant | $5,248.07 | $5,248.07 | $5,248.07 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,548.13 | $3,548.13 | $3,548.13 |
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
$4,467
AK $8,710TX $1,622
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.