How much rates vary
Facilitymedian $1,000 · 10th to 90th $550 to $5,248Professionalmedian $1,950 · 10th to 90th $1,380 to $2,344
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,258.93 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $5,888.44 | Facility | None | $4,570.88 | $4,897.79 | $5,888.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,041.74 | $2,344.23 |
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 $2,137.96 | Professional | None | $1,548.82 | $1,778.28 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,412.54 | $2,137.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,445.44 | $2,137.96 | $2,398.83 |
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 $1,698.24 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,698.24 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,454.71 | Professional | None | $2,089.30 | $2,089.30 | $2,454.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,905.46 | $1,905.46 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Facility | None | $1,000.00 | $1,000.00 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,000.00 | $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 $1,819.70 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,819.70 | $2,570.40 |
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 $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $724.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $288.40 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,071.52 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $213.80 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,041.74 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,698.24 | $2,041.74 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,412.54 Typical High $1,479.11 | Professional | 62 · Two surgeons | $1,174.90 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,691.53 Typical High $2,818.38 | Professional | 63 · Small infant | $2,290.87 | $2,691.53 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $302.00 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $302.00 Typical High $323.59 | Professional | AS · PA/NP assist | $257.04 | $302.00 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $724.44 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $288.40 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,071.52 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $213.80 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $144.54 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 7.1 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· 12th of 51
$1,950
AK $5,012TX $708
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.