How much rates vary
Facilitymedian $1,148 · 10th to 90th $550 to $5,495Professionalmedian $2,399 · 10th to 90th $1,514 to $3,890
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 $1,548.82 Median $3,890.45 Typical High $3,890.45 | Professional | None | $1,548.82 | $3,890.45 | $3,890.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,786.30 Median $5,128.61 Typical High $6,165.95 | Facility | None | $4,786.30 | $5,128.61 | $6,165.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,570.40 | $2,691.53 |
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 $1,621.81 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,905.46 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $3,890.45 Typical High $5,623.41 | Facility | None | $1,148.15 | $3,890.45 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,511.89 | $3,890.45 |
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 $1,949.84 Median $2,398.83 Typical High $2,398.83 | Facility | None | $1,949.84 | $2,398.83 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,398.83 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,290.87 | $2,691.53 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Facility | None | $1,148.15 | $1,148.15 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,148.15 | $2,511.89 |
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 $1,445.44 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,905.46 | $2,884.03 |
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 $758.58 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $758.58 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $309.03 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,148.15 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $229.09 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $154.88 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,071.52 | $2,754.23 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,290.87 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,995.26 | $2,290.87 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $269.15 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,584.89 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,380.38 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,090.30 Typical High $3,235.94 | Professional | 63 · Small infant | $2,691.53 | $3,090.30 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $407.38 Typical High $426.58 | Professional | 80 · Assistant surgeon | $354.81 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $407.38 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $354.81 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $407.38 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $346.74 Typical High $363.08 | Professional | AS · PA/NP assist | $302.00 | $346.74 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $933.25 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $371.54 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,380.38 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $275.42 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $186.21 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 22 · Increased work | $2,818.38 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,621.81 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 63 · Small infant | $2,818.38 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,949.84 |
Where Idaho sits
The same service costs 5.4 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
$2,399
AK $4,677TX $871
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.