How much rates vary
Facilitymedian $1,202 · 10th to 90th $550 to $5,623Professionalmedian $2,291 · 10th to 90th $1,622 to $2,754
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 $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,659.59 | $2,454.71 | $2,454.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,786.30 Median $5,248.07 Typical High $6,760.83 | Facility | None | $4,786.30 | $5,248.07 | $6,760.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,398.83 | $2,818.38 |
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 $1,698.24 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,698.24 | $2,041.74 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $5,495.41 | Facility | None | $1,202.26 | $2,454.71 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $2,754.23 | Professional | None | $1,659.59 | $2,454.71 | $2,754.23 |
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 $2,041.74 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,041.74 | $2,511.89 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,511.89 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,187.76 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Facility | None | $1,202.26 | $1,202.26 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,202.26 | $1,819.70 |
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 $1,380.38 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,905.46 | $2,884.03 |
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 $812.83 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $812.83 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $331.13 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,230.27 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $245.47 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $165.96 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,398.83 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,041.74 | $2,398.83 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $281.84 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,698.24 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,412.54 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,235.94 Typical High $3,388.44 | Professional | 63 · Small infant | $2,754.23 | $3,235.94 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,905.46 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,905.46 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $457.09 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $426.58 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $363.08 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $426.58 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $363.08 Typical High $389.05 | Professional | AS · PA/NP assist | $309.03 | $363.08 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $812.83 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $331.13 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,230.27 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $245.47 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $165.96 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,737.80 | $1,737.80 |
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· 13th of 51
$2,239
AK $5,754TX $813
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.