How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $14,454Professionalmedian $6,918 · 10th to 90th $4,365 to $11,220
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 $4,168.69 Median $11,220.18 Typical High $11,220.18 | Professional | None | $4,168.69 | $11,220.18 | $11,220.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $12,882.50 Median $13,803.84 Typical High $16,982.44 | Facility | None | $12,882.50 | $13,803.84 | $16,982.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $6,309.57 Median $7,413.10 Typical High $7,762.47 | Professional | None | $6,309.57 | $7,413.10 | $7,762.47 |
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 $4,466.84 Median $5,495.41 Typical High $6,456.54 | Professional | None | $4,466.84 | $5,495.41 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $5,248.07 Typical High $11,220.18 | Facility | None | $1,348.96 | $5,248.07 | $11,220.18 |
Moda Health Setting Professional Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $11,220.18 | Professional | None | $5,248.07 | $7,244.36 | $11,220.18 |
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 $5,495.41 Median $6,760.83 Typical High $6,760.83 | Facility | None | $5,495.41 | $6,760.83 | $6,760.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,413.10 | Professional | None | $6,760.83 | $6,760.83 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,606.93 Median $7,762.47 Typical High $7,762.47 | Professional | None | $6,606.93 | $7,762.47 | $7,762.47 |
Select Health Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,548.13 | Facility | None | $3,235.94 | $3,235.94 | $3,548.13 |
Select Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $7,079.46 | Professional | None | $3,235.94 | $3,235.94 | $7,079.46 |
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 $3,801.89 Median $5,128.61 Typical High $7,585.78 | Professional | None | $3,801.89 | $5,128.61 | $7,585.78 |
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 $2,089.30 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $2,089.30 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $831.76 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $8,317.64 Typical High $8,317.64 | Professional | 54 · Surgery only | $3,162.28 | $8,317.64 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $1,659.59 Typical High $1,659.59 | Professional | 55 · Aftercare only | $630.96 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $416.87 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $7,762.47 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $2,951.21 | $7,762.47 | $7,762.47 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $5,623.41 Median $6,606.93 Typical High $6,918.31 | Professional | 54 · Surgery only | $5,623.41 | $6,606.93 | $6,918.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $724.44 Typical High $758.58 | Professional | 55 · Aftercare only | $630.96 | $724.44 | $758.58 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,981.07 Median $4,570.88 Typical High $4,786.30 | Professional | 62 · Two surgeons | $3,981.07 | $4,570.88 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $7,585.78 Median $8,709.64 Typical High $9,120.11 | Professional | 63 · Small infant | $7,585.78 | $8,709.64 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,365.16 Median $5,128.61 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $4,365.16 | $5,128.61 | $5,370.32 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,000.00 Median $1,174.90 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $1,000.00 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,000.00 Median $1,174.90 Typical High $1,230.27 | Professional | 81 · Minimal assistant surgeon | $1,000.00 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,000.00 Median $1,174.90 Typical High $1,230.27 | Professional | 82 · Assistant surgeon, no resident | $1,000.00 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $851.14 Median $1,000.00 Typical High $1,047.13 | Professional | AS · PA/NP assist | $851.14 | $1,000.00 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,630.27 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $2,630.27 | $5,623.41 | $5,623.41 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,047.13 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,981.07 Median $8,317.64 Typical High $8,317.64 | Professional | 54 · Surgery only | $3,981.07 | $8,317.64 | $8,317.64 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $1,659.59 Typical High $1,659.59 | Professional | 55 · Aftercare only | $794.33 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $524.81 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,715.35 Median $7,762.47 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $3,715.35 | $7,762.47 | $7,762.47 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | 22 · Increased work | $8,128.31 | $8,128.31 | $8,128.31 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | 54 · Surgery only | $5,128.61 | $5,128.61 | $5,128.61 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 56 · Pre-op care only | $741.31 | $741.31 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 62 · Two surgeons | $4,570.88 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | 63 · Small infant | $8,128.31 | $8,128.31 | $8,128.31 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $5,495.41 | $5,495.41 | $5,495.41 |
Where Idaho sits
The same service costs 21.9 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
$6,918
AK $13,183TX $603
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.