How much rates vary
Facilitymedian $1,072 · 10th to 90th $550 to $4,786Professionalmedian $2,239 · 10th to 90th $1,380 to $2,818
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 $1,513.56 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $5,495.41 | Facility | None | $4,265.80 | $4,570.88 | $5,495.41 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,454.71 | $2,511.89 |
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 $1,445.44 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,737.80 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,071.52 | $2,818.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,454.71 | $2,818.38 |
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 $1,862.09 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,862.09 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,238.72 | $2,238.72 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,511.89 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Facility | None | $1,071.52 | $1,071.52 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,071.52 | $1,513.56 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,778.28 | $2,630.27 |
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 $758.58 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $758.58 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $302.00 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,122.02 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $229.09 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $151.36 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,089.30 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,819.70 | $2,089.30 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $234.42 | $251.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,445.44 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,288.25 | $1,445.44 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,818.38 Typical High $3,019.95 | Professional | 63 · Small infant | $2,454.71 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,621.81 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $371.54 Typical High $407.38 | Professional | 80 · Assistant surgeon | $323.59 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $371.54 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $323.59 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $371.54 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $316.23 Typical High $346.74 | Professional | AS · PA/NP assist | $275.42 | $316.23 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $758.58 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $302.00 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,122.02 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $229.09 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $151.36 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 5.6 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
$2,138
AK $5,012TX $891
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.