How much rates vary
Facilitymedian $1,023 · 10th to 90th $550 to $5,012Professionalmedian $1,950 · 10th to 90th $1,479 to $2,754
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 $1,548.82 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,754.23 | $2,754.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,365.16 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,365.16 | $4,786.30 | $5,754.40 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,862.09 | $2,041.74 | $2,398.83 |
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 $1,778.28 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,778.28 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,023.29 | $2,754.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,238.72 | $2,754.23 |
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 $1,737.80 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,737.80 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,137.96 | $2,454.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,862.09 | $1,862.09 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Facility | None | $1,023.29 | $1,023.29 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,023.29 | $1,584.89 |
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 $1,230.27 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,778.28 | $2,630.27 |
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 $776.25 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $776.25 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $309.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,148.15 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $229.09 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $154.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,467.37 Typical High $3,630.78 | Professional | 50 · Both sides | $2,884.03 | $3,467.37 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,041.74 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,737.80 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $239.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,445.44 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,202.26 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,344.23 Median $2,754.23 Typical High $2,884.03 | Professional | 63 · Small infant | $2,344.23 | $2,754.23 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,621.81 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,621.81 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $363.08 Typical High $389.05 | Professional | 80 · Assistant surgeon | $309.03 | $363.08 | $389.05 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $363.08 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $309.03 | $363.08 | $389.05 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $363.08 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $363.08 | $389.05 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $331.13 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $776.25 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $316.23 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,174.90 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $234.42 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $154.88 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,949.84 | $1,949.84 |
Where Idaho sits
The same service costs 5.9 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· 13th of 51
$1,950
AK $4,898TX $832
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.