How much rates vary
Facilitymedian $1,202 · 10th to 90th $550 to $5,888Professionalmedian $2,291 · 10th to 90th $1,622 to $3,311
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 $1,778.28 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,778.28 | $3,311.31 | $3,311.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,248.07 Median $5,623.41 Typical High $6,918.31 | Facility | None | $5,248.07 | $5,623.41 | $6,918.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,398.83 | $2,884.03 |
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 $1,819.70 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,089.30 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,202.26 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $3,311.31 | Professional | None | $1,862.09 | $2,691.53 | $3,311.31 |
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 $2,089.30 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,089.30 | $2,570.40 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,570.40 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,187.76 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Facility | None | $1,202.26 | $1,202.26 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,202.26 | $1,862.09 |
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 $2,137.96 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,137.96 | $3,090.30 |
22 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 $912.01 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $912.01 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $363.08 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,380.38 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $275.42 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $181.97 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,467.37 Median $4,073.80 Typical High $4,265.80 | Professional | 50 · Both sides | $3,467.37 | $4,073.80 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,454.71 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,041.74 | $2,454.71 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $288.40 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,445.44 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,235.94 Typical High $3,388.44 | Professional | 63 · Small infant | $2,754.23 | $3,235.94 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,905.46 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,905.46 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $436.52 Typical High $457.09 | Professional | 80 · Assistant surgeon | $363.08 | $436.52 | $457.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $436.52 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $363.08 | $436.52 | $457.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $436.52 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $436.52 | $457.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $371.54 Typical High $389.05 | Professional | AS · PA/NP assist | $309.03 | $371.54 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $933.25 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $371.54 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,380.38 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $275.42 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $186.21 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,290.87 | $2,290.87 |
Where Idaho sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 14th of 51
$2,291
AK $5,888UT $1,000
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.