How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,380 to $25,704Professionalmedian $1,288 · 10th to 90th $891 to $1,549
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,412.54 Typical High $1,412.54 | Professional | None | $831.76 | $1,412.54 | $1,412.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,918.31 Median $7,762.47 Typical High $30,902.95 | Facility | None | $6,918.31 | $7,762.47 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,445.44 | $1,548.82 |
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 $1,023.29 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,174.90 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $5,495.41 | Facility | None | $660.69 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,548.82 | Professional | None | $954.99 | $1,412.54 | $1,548.82 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,122.02 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,380.38 | $2,454.71 |
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 $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,258.93 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Facility | None | $660.69 | $660.69 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,023.29 | Professional | None | $660.69 | $660.69 | $1,023.29 |
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 $870.96 Median $1,174.90 Typical High $1,659.59 | Professional | None | $870.96 | $1,174.90 | $1,659.59 |
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 $478.63 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $478.63 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $190.55 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $707.95 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $141.25 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $95.50 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $660.69 | $1,000.00 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $977.24 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | 63 · Small infant | $1,513.56 | $1,778.28 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $213.80 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $478.63 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $190.55 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $707.95 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $141.25 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $95.50 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $660.69 | $1,000.00 | $1,000.00 |
Where Idaho sits
The same service costs 11.0 times more in Oklahoma 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· 15th of 51
$1,413
OK $5,888UT $537
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.