How much rates vary
Facilitymedian $1,000 · 10th to 90th $550 to $4,677Professionalmedian $2,089 · 10th to 90th $1,288 to $3,311
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 $1,318.26 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,318.26 | $3,311.31 | $3,311.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $4,365.16 Typical High $5,248.07 | Facility | None | $4,073.80 | $4,365.16 | $5,248.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,238.72 | $2,344.23 |
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 $1,380.38 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,659.59 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,187.76 | $3,311.31 |
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 $1,698.24 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,698.24 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,238.72 | Professional | None | $2,089.30 | $2,089.30 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,344.23 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Facility | None | $1,000.00 | $1,000.00 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,000.00 | $2,137.96 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,584.89 | $2,454.71 |
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 $660.69 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $660.69 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $263.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $977.24 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $199.53 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $131.83 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $912.01 | $2,344.23 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,995.26 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,737.80 | $1,995.26 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,380.38 Typical High $1,445.44 | Professional | 62 · Two surgeons | $1,202.26 | $1,380.38 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,630.27 Typical High $2,818.38 | Professional | 63 · Small infant | $2,290.87 | $2,630.27 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,548.82 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $354.81 Typical High $371.54 | Professional | 80 · Assistant surgeon | $309.03 | $354.81 | $371.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $354.81 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $309.03 | $354.81 | $371.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $354.81 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $354.81 | $371.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $302.00 Typical High $316.23 | Professional | AS · PA/NP assist | $263.03 | $302.00 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $794.33 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $316.23 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,202.26 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $239.88 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $158.49 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 22 · Increased work | $2,454.71 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 62 · Two surgeons | $1,380.38 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 63 · Small infant | $2,454.71 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Idaho sits
The same service costs 5.5 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
$2,089
AK $4,266TX $776
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.