How much rates vary
Facilitymedian $4,169 · 10th to 90th $550 to $19,055Professionalmedian $8,511 · 10th to 90th $5,495 to $14,125
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 $5,011.87 Median $14,125.38 Typical High $14,125.38 | Professional | None | $5,011.87 | $14,125.38 | $14,125.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,011.87 Median $17,782.79 Typical High $19,952.62 | Facility | None | $5,011.87 | $17,782.79 | $19,952.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $7,762.47 Median $9,120.11 Typical High $9,772.37 | Professional | None | $7,762.47 | $9,120.11 | $9,772.37 |
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 $5,888.44 Median $6,918.31 Typical High $8,128.31 | Professional | None | $5,888.44 | $6,918.31 | $8,128.31 |
Moda Health Setting Facility Modifier None Typical Low $3,981.07 Median $6,606.93 Typical High $14,125.38 | Facility | None | $3,981.07 | $6,606.93 | $14,125.38 |
Moda Health Setting Professional Modifier None Typical Low $6,606.93 Median $9,120.11 Typical High $14,125.38 | Professional | None | $6,606.93 | $9,120.11 | $14,125.38 |
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 $6,918.31 Median $8,511.38 Typical High $8,511.38 | Facility | None | $6,918.31 | $8,511.38 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $9,332.54 | Professional | None | $8,511.38 | $8,511.38 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,317.64 Median $9,772.37 Typical High $9,772.37 | Professional | None | $8,317.64 | $9,772.37 | $9,772.37 |
Select Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,365.16 | Facility | None | $3,981.07 | $3,981.07 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $8,912.51 | Professional | None | $3,981.07 | $3,981.07 | $8,912.51 |
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 $5,248.07 Median $6,918.31 Typical High $10,471.29 | Professional | None | $5,248.07 | $6,918.31 | $10,471.29 |
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 $2,754.23 Median $7,079.46 Typical High $7,079.46 | Professional | 52 · Reduced service | $2,754.23 | $7,079.46 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $2,818.38 Typical High $2,818.38 | Professional | 53 · Discontinued | $1,122.02 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,168.69 Median $10,471.29 Typical High $10,471.29 | Professional | 54 · Surgery only | $4,168.69 | $10,471.29 | $10,471.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $2,089.30 Typical High $2,089.30 | Professional | 55 · Aftercare only | $831.76 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $1,412.54 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $549.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,890.45 Median $9,772.37 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $3,890.45 | $9,772.37 | $9,772.37 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $7,079.46 Median $8,128.31 Typical High $8,511.38 | Professional | 54 · Surgery only | $7,079.46 | $8,128.31 | $8,511.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $891.25 Typical High $954.99 | Professional | 55 · Aftercare only | $776.25 | $891.25 | $954.99 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $4,897.79 Median $5,623.41 Typical High $5,888.44 | Professional | 62 · Two surgeons | $4,897.79 | $5,623.41 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $9,332.54 Median $10,715.19 Typical High $11,220.18 | Professional | 63 · Small infant | $9,332.54 | $10,715.19 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,495.41 Median $6,309.57 Typical High $6,606.93 | Professional | 78 · Unplanned return to OR | $5,495.41 | $6,309.57 | $6,606.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 81 · Minimal assistant surgeon | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 82 · Assistant surgeon, no resident | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | AS · PA/NP assist | $1,047.13 | $1,230.27 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,311.31 Median $7,079.46 Typical High $7,079.46 | Professional | 52 · Reduced service | $3,311.31 | $7,079.46 | $7,079.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,318.26 Median $2,818.38 Typical High $2,818.38 | Professional | 53 · Discontinued | $1,318.26 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,897.79 Median $10,471.29 Typical High $10,471.29 | Professional | 54 · Surgery only | $4,897.79 | $10,471.29 | $10,471.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $977.24 Median $2,089.30 Typical High $2,089.30 | Professional | 55 · Aftercare only | $977.24 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $660.69 Median $1,412.54 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $660.69 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,570.88 Median $9,772.37 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $4,570.88 | $9,772.37 | $9,772.37 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | 22 · Increased work | $10,232.93 | $10,232.93 | $10,232.93 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | 54 · Surgery only | $6,456.54 | $6,456.54 | $6,456.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 56 · Pre-op care only | $933.25 | $933.25 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | 62 · Two surgeons | $5,754.40 | $5,754.40 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | 63 · Small infant | $10,232.93 | $10,232.93 | $10,232.93 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $6,918.31 | $6,918.31 | $6,918.31 |
Where Idaho sits
The same service costs 20.0 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· 11th of 51
$8,511
AK $15,488TX $776
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.