How much rates vary
Facilitymedian $891 · 10th to 90th $550 to $3,981Professionalmedian $1,820 · 10th to 90th $1,148 to $2,344
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 $1,258.93 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,258.93 | $2,344.23 | $2,344.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $3,715.35 Typical High $4,466.84 | Facility | None | $3,467.37 | $3,715.35 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,089.30 | Professional | None | $1,737.80 | $2,041.74 | $2,089.30 |
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 $1,202.26 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,412.54 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $5,495.41 | Facility | None | $891.25 | $2,344.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,258.93 | $2,041.74 | $2,344.23 |
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 $1,513.56 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,513.56 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,862.09 | $1,862.09 | $2,344.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,698.24 | $2,041.74 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $977.24 | Facility | None | $891.25 | $891.25 | $977.24 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
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 $977.24 Median $1,445.44 Typical High $2,137.96 | Professional | None | $977.24 | $1,445.44 | $2,137.96 |
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 $616.60 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $616.60 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $251.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $933.25 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $186.21 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $125.89 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $870.96 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,513.56 | $1,737.80 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $208.93 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,202.26 Typical High $1,318.26 | Professional | 62 · Two surgeons | $1,047.13 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,041.74 Median $2,344.23 Typical High $2,511.89 | Professional | 63 · Small infant | $2,041.74 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 80 · Assistant surgeon | $269.15 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $269.15 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $309.03 | $338.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $263.03 Typical High $288.40 | Professional | AS · PA/NP assist | $229.09 | $263.03 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $616.60 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $251.19 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $933.25 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $186.21 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $125.89 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $870.96 | $1,621.81 | $1,621.81 |
Where Idaho sits
The same service costs 18.6 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
$1,778
AK $4,169TX $224
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.