How much rates vary
Facilitymedian $3,548 · 10th to 90th $550 to $16,218Professionalmedian $7,586 · 10th to 90th $4,786 to $12,303
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 $4,677.35 Median $12,302.69 Typical High $12,302.69 | Professional | None | $4,677.35 | $12,302.69 | $12,302.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $14,454.40 Median $15,488.17 Typical High $18,620.87 | Facility | None | $14,454.40 | $15,488.17 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $6,918.31 Median $8,128.31 Typical High $8,511.38 | Professional | None | $6,918.31 | $8,128.31 | $8,511.38 |
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 $4,897.79 Median $6,025.60 Typical High $6,918.31 | Professional | None | $4,897.79 | $6,025.60 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $17,378.01 | Facility | None | $3,548.13 | $5,754.40 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $5,754.40 Median $7,943.28 Typical High $12,302.69 | Professional | None | $5,754.40 | $7,943.28 | $12,302.69 |
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 $6,165.95 Median $7,413.10 Typical High $7,413.10 | Facility | None | $6,165.95 | $7,413.10 | $7,413.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,128.31 | Professional | None | $7,413.10 | $7,413.10 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,244.36 Median $8,511.38 Typical High $8,511.38 | Professional | None | $7,244.36 | $8,511.38 | $8,511.38 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,890.45 | Facility | None | $3,548.13 | $3,548.13 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $7,762.47 | Professional | None | $3,548.13 | $3,548.13 | $7,762.47 |
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 $4,265.80 Median $5,754.40 Typical High $8,511.38 | Professional | None | $4,265.80 | $5,754.40 | $8,511.38 |
28 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 $2,398.83 Median $6,025.60 Typical High $6,025.60 | Professional | 52 · Reduced service | $2,398.83 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $2,454.71 Typical High $2,454.71 | Professional | 53 · Discontinued | $977.24 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $3,630.78 | $9,120.11 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $724.44 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $1,230.27 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $478.63 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $3,388.44 | $8,511.38 | $8,511.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $6,165.95 Median $7,244.36 Typical High $7,585.78 | Professional | 54 · Surgery only | $6,165.95 | $7,244.36 | $7,585.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $794.33 Typical High $831.76 | Professional | 55 · Aftercare only | $691.83 | $794.33 | $831.76 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $4,365.16 Median $5,011.87 Typical High $5,248.07 | Professional | 62 · Two surgeons | $4,365.16 | $5,011.87 | $5,248.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $8,317.64 Median $9,549.93 Typical High $10,000.00 | Professional | 63 · Small infant | $8,317.64 | $9,549.93 | $10,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,897.79 Median $5,623.41 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $4,897.79 | $5,623.41 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $1,096.48 | $1,288.25 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | 81 · Minimal assistant surgeon | $1,096.48 | $1,288.25 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | 82 · Assistant surgeon, no resident | $1,096.48 | $1,288.25 | $1,348.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $933.25 Median $1,096.48 Typical High $1,148.15 | Professional | AS · PA/NP assist | $933.25 | $1,096.48 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,884.03 Median $6,025.60 Typical High $6,025.60 | Professional | 52 · Reduced service | $2,884.03 | $6,025.60 | $6,025.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $2,454.71 Typical High $2,454.71 | Professional | 53 · Discontinued | $1,148.15 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,265.80 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $4,265.80 | $9,120.11 | $9,120.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $851.14 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $1,230.27 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $575.44 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,981.07 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $3,981.07 | $8,511.38 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | 22 · Increased work | $8,912.51 | $8,912.51 | $8,912.51 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | 54 · Surgery only | $5,623.41 | $5,623.41 | $5,623.41 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 56 · Pre-op care only | $812.83 | $812.83 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | 62 · Two surgeons | $5,011.87 | $5,011.87 | $5,011.87 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | 63 · Small infant | $8,912.51 | $8,912.51 | $8,912.51 |
MountainHealth Co-op Setting Professional Modifier 66 · Surgical team Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 66 · Surgical team | $3,630.78 | $3,630.78 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $6,025.60 | $6,025.60 | $6,025.60 |
Where Idaho sits
The same service costs 20.9 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· 10th of 51
$7,586
AK $14,125TX $676
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.