How much rates vary
Facilitymedian $1,122 · 10th to 90th $550 to $5,370Professionalmedian $2,344 · 10th to 90th $1,445 to $3,802
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 $1,479.11 Median $3,801.89 Typical High $3,801.89 | Professional | None | $1,479.11 | $3,801.89 | $3,801.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,677.35 Median $5,011.87 Typical High $6,025.60 | Facility | None | $4,677.35 | $5,011.87 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,511.89 | $2,630.27 |
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 $1,548.82 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,862.09 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $3,801.89 Typical High $5,495.41 | Facility | None | $1,122.02 | $3,801.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,454.71 | $3,801.89 |
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 $1,905.46 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,905.46 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,511.89 | Professional | None | $2,344.23 | $2,344.23 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,238.72 | $2,630.27 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Facility | None | $1,122.02 | $1,122.02 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,122.02 | $2,398.83 |
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 $1,412.54 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,819.70 | $2,818.38 |
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 $741.31 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $741.31 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $295.12 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,096.48 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $218.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $147.91 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $2,630.27 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,238.72 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,949.84 | $2,238.72 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,548.82 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,348.96 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | 63 · Small infant | $2,570.40 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,737.80 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $398.11 Typical High $416.87 | Professional | 80 · Assistant surgeon | $346.74 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $398.11 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $346.74 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $398.11 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | AS · PA/NP assist | $295.12 | $338.84 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $891.25 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $354.81 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,348.96 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $269.15 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $177.83 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,258.93 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 22 · Increased work | $2,754.23 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $251.19 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,548.82 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 63 · Small infant | $2,754.23 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $1,862.09 |
Where Idaho sits
The same service costs 21.4 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
$2,344
AK $4,571TX $214
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.