How much rates vary
Facilitymedian $7,244 · 10th to 90th $2,239 to $25,704Professionalmedian $2,291 · 10th to 90th $1,380 to $3,631
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $3,630.78 Typical High $3,630.78 | Professional | None | $1,380.38 | $3,630.78 | $3,630.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,762.47 Median $16,595.87 Typical High $30,902.95 | Facility | None | $7,762.47 | $16,595.87 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,041.74 | $2,398.83 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,778.28 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $3,630.78 Typical High $5,495.41 | Facility | None | $1,288.25 | $3,630.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,344.23 | $3,630.78 |
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 $1,819.70 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,819.70 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,398.83 | Professional | None | $2,238.72 | $2,238.72 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $24,547.09 Typical High $33,884.42 | Facility | None | $17,378.01 | $24,547.09 | $33,884.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,511.89 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $23,442.29 | Facility | None | $1,071.52 | $1,071.52 | $23,442.29 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,071.52 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,698.24 | $2,691.53 |
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 $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $660.69 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $263.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,000.00 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $199.53 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $131.83 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $933.25 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,137.96 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,862.09 | $2,137.96 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $234.42 | $251.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,479.11 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,288.25 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,818.38 Typical High $3,019.95 | Professional | 63 · Small infant | $2,454.71 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,659.59 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $380.19 Typical High $398.11 | Professional | 80 · Assistant surgeon | $331.13 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $380.19 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $331.13 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $380.19 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $323.59 Typical High $338.84 | Professional | AS · PA/NP assist | $281.84 | $323.59 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $851.14 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $338.84 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,288.25 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $257.04 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $169.82 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,202.26 | $2,511.89 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 22 · Increased work | $2,630.27 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,513.56 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 63 · Small infant | $2,630.27 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 25.7 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
$2,344
AK $5,129TX $200
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.