How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,445 to $8,511Professionalmedian $1,318 · 10th to 90th $912 to $1,622
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,621.81 Typical High $1,621.81 | Professional | None | $831.76 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $9,120.11 | Facility | None | $2,344.23 | $4,073.80 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,513.56 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,174.90 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $5,495.41 | Facility | None | $954.99 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,548.82 | $1,621.81 |
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 $1,174.90 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,445.44 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $6,456.54 | Facility | None | $691.83 | $707.95 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,047.13 | Professional | None | $691.83 | $691.83 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,698.24 | Professional | None | $870.96 | $1,202.26 | $1,698.24 |
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 $512.86 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $512.86 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $758.58 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $102.33 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $707.95 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,380.38 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,174.90 | $1,380.38 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $162.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,023.29 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,862.09 Typical High $1,949.84 | Professional | 63 · Small infant | $1,548.82 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,071.52 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,071.52 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $263.03 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $263.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $245.47 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $208.93 | $245.47 | $263.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $245.47 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $245.47 | $263.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $223.87 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $537.03 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $213.80 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $812.83 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $162.18 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $107.15 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $758.58 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 6.6 times more in Oklahoma 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· 15th of 51
$1,549
OK $3,802UT $575
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.