How much rates vary
Facilitymedian $1,000 · 10th to 90th $550 to $4,786Professionalmedian $2,138 · 10th to 90th $1,318 to $3,388
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 $1,318.26 Median $3,388.44 Typical High $3,388.44 | Professional | None | $1,318.26 | $3,388.44 | $3,388.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $5,370.32 | Facility | None | $4,168.69 | $4,466.84 | $5,370.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,949.84 | $2,238.72 | $2,344.23 |
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 $1,412.54 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,659.59 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,388.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,187.76 | $3,388.44 |
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 $1,698.24 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,698.24 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,238.72 | Professional | None | $2,089.30 | $2,089.30 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,344.23 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Facility | None | $1,000.00 | $1,000.00 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,000.00 | $2,187.76 |
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 $1,258.93 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,621.81 | $2,511.89 |
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 $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $660.69 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $269.15 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,000.00 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $199.53 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $131.83 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $933.25 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,995.26 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,737.80 | $1,995.26 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $1,479.11 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,344.23 Median $2,691.53 Typical High $2,818.38 | Professional | 63 · Small infant | $2,344.23 | $2,691.53 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,548.82 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,548.82 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $354.81 Typical High $380.19 | Professional | 80 · Assistant surgeon | $309.03 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $354.81 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $309.03 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $354.81 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $302.00 Typical High $323.59 | Professional | AS · PA/NP assist | $263.03 | $302.00 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $794.33 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $323.59 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,202.26 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $239.88 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $162.18 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,398.83 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 22 · Increased work | $2,454.71 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,412.54 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 63 · Small infant | $2,454.71 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
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
$2,089
AK $4,266TX $794
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.