How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,514 to $18,621Professionalmedian $1,514 · 10th to 90th $1,072 to $1,905
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 $977.24 Median $1,905.46 Typical High $1,905.46 | Professional | None | $977.24 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $6,760.83 Typical High $23,988.33 | Facility | None | $2,187.76 | $6,760.83 | $23,988.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,737.80 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,495.41 | $6,165.95 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,380.38 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $5,495.41 | Facility | None | $1,096.48 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,778.28 | $1,905.46 |
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 $1,348.96 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,348.96 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,659.59 | $2,884.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $20,892.96 Typical High $30,199.52 | Facility | None | $8,511.38 | $20,892.96 | $30,199.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,445.44 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $812.83 Typical High $9,332.54 | Facility | None | $794.33 | $812.83 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,202.26 | Professional | None | $794.33 | $794.33 | $1,202.26 |
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 $1,000.00 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,380.38 | $1,995.26 |
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 $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,584.89 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $186.21 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,096.48 Typical High $1,174.90 | Professional | 62 · Two surgeons | $933.25 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,778.28 Median $2,137.96 Typical High $2,238.72 | Professional | 63 · Small infant | $1,778.28 | $2,137.96 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $302.00 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $281.84 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $239.88 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $281.84 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $251.19 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $1,318.26 |
Where Idaho sits
The same service costs 6.3 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· 17th of 51
$1,738
OK $4,169UT $661
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.