How much rates vary
Facilitymedian $955 · 10th to 90th $550 to $4,677Professionalmedian $1,820 · 10th to 90th $1,380 to $2,570
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 $4,677.35 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,677.35 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,445.44 | $2,570.40 | $2,570.40 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $5,370.32 | Facility | None | $4,073.80 | $4,466.84 | $5,370.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,905.46 | $2,238.72 |
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 $1,445.44 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,659.59 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $4,677.35 | Facility | None | $954.99 | $2,570.40 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,445.44 | $2,187.76 | $2,570.40 |
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 $1,621.81 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,995.26 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,995.26 | $1,995.26 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,737.80 | $1,737.80 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Facility | None | $954.99 | $954.99 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,479.11 | Professional | None | $954.99 | $954.99 | $1,479.11 |
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 $1,148.15 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,659.59 | $2,454.71 |
21 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 $724.44 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $724.44 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $288.40 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,071.52 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $213.80 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $144.54 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,905.46 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,621.81 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $223.87 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,122.02 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,137.96 Median $2,570.40 Typical High $2,691.53 | Professional | 63 · Small infant | $2,137.96 | $2,570.40 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,479.11 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $309.03 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $724.44 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $288.40 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,096.48 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $218.78 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $144.54 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,819.70 | $1,819.70 |
Where Idaho sits
The same service costs 5.8 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
$1,820
AK $4,571UT $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.