How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,514 to $12,303Professionalmedian $1,622 · 10th to 90th $1,148 to $2,042
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 $1,202.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,202.26 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,168.69 Typical High $13,489.63 | Facility | None | $2,187.76 | $4,168.69 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,819.70 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $4,570.88 | Facility | None | $3,019.95 | $3,388.44 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,479.11 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $5,495.41 | Facility | None | $1,174.90 | $2,041.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,905.46 | $2,041.74 |
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 $1,445.44 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,445.44 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,778.28 | $1,778.28 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,982.44 | Facility | None | $8,511.38 | $12,302.69 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,548.82 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $7,079.46 | Facility | None | $851.14 | $870.96 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,288.25 | Professional | None | $851.14 | $851.14 | $1,288.25 |
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 $1,047.13 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,445.44 | $2,089.30 |
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 $602.56 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $602.56 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $239.88 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $891.25 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $177.83 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $120.23 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $831.76 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $199.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,174.90 Typical High $1,258.93 | Professional | 62 · Two surgeons | $1,000.00 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,905.46 Median $2,290.87 Typical High $2,398.83 | Professional | 63 · Small infant | $1,905.46 | $2,290.87 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,318.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,318.26 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $302.00 Typical High $316.23 | Professional | 80 · Assistant surgeon | $257.04 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $302.00 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $257.04 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $302.00 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $269.15 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $660.69 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $263.03 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,000.00 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $199.53 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $131.83 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $933.25 | $1,412.54 | $1,412.54 |
Where Idaho sits
The same service costs 5.6 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 $4,074UT $724
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.