How much rates vary
Facilitymedian $3,548 · 10th to 90th $2,089 to $12,303Professionalmedian $2,291 · 10th to 90th $1,585 to $2,818
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 $1,659.59 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,090.30 Median $5,011.87 Typical High $13,489.63 | Facility | None | $3,090.30 | $5,011.87 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,570.40 | $2,754.23 |
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 $1,778.28 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,041.74 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,818.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,691.53 | $2,818.38 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Professional | None | $2,454.71 | $2,454.71 | $4,265.80 |
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 $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $9,332.54 | Facility | None | $1,174.90 | $1,202.26 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,174.90 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,513.56 | $2,041.74 | $2,951.21 |
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 $831.76 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $831.76 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $331.13 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,258.93 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $251.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $165.96 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,344.23 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,995.26 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,659.59 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,380.38 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,162.28 Typical High $3,311.31 | Professional | 63 · Small infant | $2,691.53 | $3,162.28 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,862.09 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $416.87 Typical High $446.68 | Professional | 80 · Assistant surgeon | $354.81 | $416.87 | $446.68 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $416.87 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $354.81 | $416.87 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $416.87 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $416.87 | $446.68 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | AS · PA/NP assist | $302.00 | $354.81 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $933.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $371.54 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,380.38 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $275.42 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $186.21 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,995.26 | $1,995.26 |
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· 12th of 51
$2,512
AK $5,623UT $977
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.