How much rates vary
Facilitymedian $1,288 · 10th to 90th $550 to $4,677Professionalmedian $2,570 · 10th to 90th $1,622 to $3,467
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 $3,467.37 Typical High $3,467.37 | Professional | None | $1,513.56 | $3,467.37 | $3,467.37 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $5,370.32 | Facility | None | $3,890.45 | $4,365.16 | $5,370.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,951.21 | $3,019.95 |
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 $1,778.28 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,778.28 | $2,089.30 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $5,495.41 | Facility | None | $1,288.25 | $3,467.37 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $3,467.37 | Professional | None | $1,819.70 | $2,951.21 | $3,467.37 |
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 $2,187.76 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,187.76 | $2,691.53 | $2,691.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,691.53 | $2,691.53 | $3,388.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,511.89 | $3,019.95 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Facility | None | $1,288.25 | $1,288.25 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,288.25 | $1,819.70 |
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 $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
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 $758.58 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $758.58 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $302.00 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,148.15 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $229.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $151.36 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,071.52 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,511.89 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,187.76 | $2,511.89 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $281.84 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,737.80 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,513.56 | $1,737.80 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,884.03 Median $3,311.31 Typical High $3,630.78 | Professional | 63 · Small infant | $2,884.03 | $3,311.31 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,949.84 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,949.84 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $446.68 Typical High $489.78 | Professional | 80 · Assistant surgeon | $389.05 | $446.68 | $489.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $446.68 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $389.05 | $446.68 | $489.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $446.68 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $446.68 | $489.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $380.19 Typical High $416.87 | Professional | AS · PA/NP assist | $331.13 | $380.19 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $912.01 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $363.08 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,380.38 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $275.42 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $181.97 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,398.83 | $2,398.83 |
Where Idaho sits
The same service costs 8.5 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
$2,512
AK $6,166TX $724
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.