How much rates vary
Facilitymedian $1,820 · 10th to 90th $832 to $3,981Professionalmedian $1,122 · 10th to 90th $776 to $1,349
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 $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | None | $776.25 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $3,311.31 | Facility | None | $2,570.40 | $2,754.23 | $3,311.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,174.90 | $1,348.96 |
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 $870.96 Median $1,023.29 Typical High $1,202.26 | Professional | None | $870.96 | $1,023.29 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,230.27 Typical High $5,495.41 | Facility | None | $776.25 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,380.38 | Professional | None | $831.76 | $1,230.27 | $1,380.38 |
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 $977.24 Median $1,202.26 Typical High $1,202.26 | Facility | None | $977.24 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $616.60 | Facility | None | $575.44 | $575.44 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $891.25 | Professional | None | $575.44 | $575.44 | $891.25 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,445.44 | Professional | None | $691.83 | $1,047.13 | $1,445.44 |
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 $416.87 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $416.87 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $165.96 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $616.60 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $123.03 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $83.18 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $575.44 | $870.96 | $870.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,174.90 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $134.90 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $851.14 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $851.14 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,318.26 Median $1,548.82 Typical High $1,621.81 | Professional | 63 · Small infant | $1,318.26 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $954.99 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $173.78 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $186.21 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $416.87 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $165.96 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $616.60 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $123.03 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $83.18 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $575.44 | $870.96 | $870.96 |
Where Idaho sits
The same service costs 6.9 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· 13th of 51
$1,202
OK $3,020TX $437
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.