How much rates vary
Facilitymedian $1,230 · 10th to 90th $550 to $5,888Professionalmedian $2,692 · 10th to 90th $1,660 to $4,266
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $4,265.80 Typical High $4,265.80 | Professional | None | $1,621.81 | $4,265.80 | $4,265.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,128.61 Median $5,495.41 Typical High $6,606.93 | Facility | None | $5,128.61 | $5,495.41 | $6,606.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,818.38 | $2,951.21 |
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 $1,778.28 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,089.30 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $1,513.56 | $4,265.80 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,995.26 | $2,754.23 | $4,265.80 |
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 $2,137.96 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,137.96 | $2,570.40 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,570.40 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,951.21 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Facility | None | $1,230.27 | $1,230.27 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,230.27 | $2,691.53 |
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 $1,479.11 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,995.26 | $3,162.28 |
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 $776.25 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $776.25 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $316.23 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,174.90 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $234.42 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $154.88 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,096.48 | $2,951.21 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,137.96 | $2,511.89 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $239.88 | $275.42 | $288.40 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,737.80 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,513.56 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,884.03 Median $3,311.31 Typical High $3,467.37 | Professional | 63 · Small infant | $2,884.03 | $3,311.31 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,949.84 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,949.84 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $446.68 Typical High $467.74 | Professional | 80 · Assistant surgeon | $380.19 | $446.68 | $467.74 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $446.68 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $380.19 | $446.68 | $467.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $446.68 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $446.68 | $467.74 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $380.19 Typical High $398.11 | Professional | AS · PA/NP assist | $323.59 | $380.19 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,000.00 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $398.11 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,513.56 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $302.00 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $199.53 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 22 · Increased work | $3,090.30 | $3,090.30 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $281.84 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,737.80 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 63 · Small infant | $3,090.30 | $3,090.30 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,089.30 |
Where Idaho sits
The same service costs 5.2 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
$2,630
AK $5,129TX $977
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.