How much rates vary
Facilitymedian $3,020 · 10th to 90th $550 to $13,804Professionalmedian $6,607 · 10th to 90th $3,981 to $10,233
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 $4,073.80 Median $10,232.93 Typical High $10,232.93 | Professional | None | $4,073.80 | $10,232.93 | $10,232.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $7,585.78 Typical High $7,585.78 | Professional | 54 · Surgery only | $3,019.95 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $7,079.46 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $2,818.38 | $7,079.46 | $7,079.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $12,302.69 Median $13,489.63 Typical High $16,218.10 | Facility | None | $12,302.69 | $13,489.63 | $16,218.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $5,754.40 Median $6,760.83 Typical High $7,079.46 | Professional | None | $5,754.40 | $6,760.83 | $7,079.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $5,248.07 Median $6,025.60 Typical High $6,309.57 | Professional | 54 · Surgery only | $5,248.07 | $6,025.60 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,073.80 Median $4,677.35 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $4,073.80 | $4,677.35 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $3,019.95 Median $5,495.41 Typical High $14,454.40 | Facility | None | $3,019.95 | $5,495.41 | $14,454.40 |
Moda Health Setting Professional Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $10,232.93 | Professional | None | $4,786.30 | $6,606.93 | $10,232.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $7,585.78 Typical High $7,585.78 | Professional | 54 · Surgery only | $3,630.78 | $7,585.78 | $7,585.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $7,079.46 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $3,388.44 | $7,079.46 | $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 $5,128.61 Median $6,309.57 Typical High $6,309.57 | Facility | None | $5,128.61 | $6,309.57 | $6,309.57 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,760.83 | Professional | None | $6,309.57 | $6,309.57 | $6,760.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $4,786.30 | $4,786.30 | $4,786.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $5,128.61 | $5,128.61 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,025.60 Median $7,079.46 Typical High $7,079.46 | Professional | None | $6,025.60 | $7,079.46 | $7,079.46 |
Select Health Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,235.94 | Facility | None | $3,019.95 | $3,019.95 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,606.93 | Professional | None | $3,019.95 | $3,019.95 | $6,606.93 |
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 $5,011.87 Typical High $7,413.10 | Professional | None | $3,801.89 | $5,011.87 | $7,413.10 |
20 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 $2,041.74 Median $5,128.61 Typical High $5,128.61 | Professional | 52 · Reduced service | $2,041.74 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $2,041.74 Typical High $2,041.74 | Professional | 53 · Discontinued | $812.83 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $1,513.56 Typical High $1,513.56 | Professional | 55 · Aftercare only | $602.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $1,023.29 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $407.38 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $676.08 Typical High $707.95 | Professional | 55 · Aftercare only | $575.44 | $676.08 | $707.95 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,630.78 Median $4,168.69 Typical High $4,365.16 | Professional | 62 · Two surgeons | $3,630.78 | $4,168.69 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $6,918.31 Median $8,128.31 Typical High $8,511.38 | Professional | 63 · Small infant | $6,918.31 | $8,128.31 | $8,511.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $933.25 Median $1,071.52 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $933.25 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $933.25 Median $1,071.52 Typical High $1,122.02 | Professional | 81 · Minimal assistant surgeon | $933.25 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $933.25 Median $1,071.52 Typical High $1,122.02 | Professional | 82 · Assistant surgeon, no resident | $933.25 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $794.33 Median $912.01 Typical High $954.99 | Professional | AS · PA/NP assist | $794.33 | $912.01 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,398.83 Median $5,128.61 Typical High $5,128.61 | Professional | 52 · Reduced service | $2,398.83 | $5,128.61 | $5,128.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $2,041.74 Typical High $2,041.74 | Professional | 53 · Discontinued | $954.99 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $1,513.56 Typical High $1,513.56 | Professional | 55 · Aftercare only | $724.44 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $1,023.29 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $478.63 | $1,023.29 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | 22 · Increased work | $7,413.10 | $7,413.10 | $7,413.10 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 56 · Pre-op care only | $676.08 | $676.08 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 62 · Two surgeons | $4,265.80 | $4,265.80 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | 63 · Small infant | $7,413.10 | $7,413.10 | $7,413.10 |
MountainHealth Co-op Setting Professional Modifier 66 · Surgical team Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 66 · Surgical team | $3,019.95 | $3,019.95 | $3,019.95 |
Where Idaho sits
The same service costs 27.5 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
$6,607
AK $14,454TX $525
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.