How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,905 to $22,909Professionalmedian $1,778 · 10th to 90th $1,288 to $2,138
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 $1,288.25 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,623.41 Median $8,709.64 Typical High $26,915.35 | Facility | None | $5,623.41 | $8,709.64 | $26,915.35 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,737.80 | $1,949.84 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,621.81 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $5,495.41 | Facility | None | $1,288.25 | $1,949.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,949.84 | $2,137.96 |
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 $1,548.82 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,548.82 | $1,905.46 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,905.46 | $1,905.46 | $3,388.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $24,547.09 Typical High $33,884.42 | Facility | None | $17,378.01 | $24,547.09 | $33,884.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,737.80 | $1,737.80 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $11,220.18 | Facility | None | $912.01 | $933.25 | $11,220.18 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,412.54 | Professional | None | $912.01 | $912.01 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,659.59 | $2,344.23 |
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 $645.65 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $645.65 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $263.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $977.24 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $912.01 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $204.17 | $213.80 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,258.93 Typical High $1,348.96 | Professional | 62 · Two surgeons | $1,071.52 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,041.74 Median $2,454.71 Typical High $2,570.40 | Professional | 63 · Small infant | $2,041.74 | $2,454.71 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $338.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $275.42 | $323.59 | $338.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $323.59 | $338.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $275.42 Typical High $288.40 | Professional | AS · PA/NP assist | $234.42 | $275.42 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $645.65 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $263.03 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $977.24 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $128.82 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $912.01 | $1,380.38 | $1,380.38 |
Where Idaho sits
The same service costs 8.7 times more in Oklahoma 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· 16th of 51
$1,950
OK $6,166TX $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.