How much rates vary
Facilitymedian $2,042 · 10th to 90th $550 to $9,120Professionalmedian $4,266 · 10th to 90th $2,630 to $5,495
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 $2,884.03 Median $5,495.41 Typical High $5,495.41 | Professional | None | $2,884.03 | $5,495.41 | $5,495.41 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $10,715.19 | Facility | None | $7,585.78 | $8,912.51 | $10,715.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $4,897.79 | Professional | None | $3,890.45 | $4,570.88 | $4,897.79 |
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 $2,818.38 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,818.38 | $3,388.44 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $7,943.28 | Facility | None | $2,041.74 | $5,495.41 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $5,495.41 | Professional | None | $2,951.21 | $4,677.35 | $5,495.41 |
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 $3,467.37 Median $4,265.80 Typical High $4,265.80 | Facility | None | $3,467.37 | $4,265.80 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,370.32 | Professional | None | $4,265.80 | $4,265.80 | $5,370.32 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $5,495.41 | Professional | None | $4,073.80 | $4,897.79 | $5,495.41 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,238.72 | Facility | None | $2,041.74 | $2,041.74 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,041.74 | $2,951.21 |
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 $2,344.23 Median $3,467.37 Typical High $5,128.61 | Professional | None | $2,344.23 | $3,467.37 | $5,128.61 |
22 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 $1,445.44 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,445.44 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $575.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,137.96 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $426.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $288.40 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,995.26 | $3,890.45 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $5,754.40 Median $6,606.93 Typical High $7,079.46 | Professional | 50 · Both sides | $5,754.40 | $6,606.93 | $7,079.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,981.07 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,467.37 | $3,981.07 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $436.52 Typical High $478.63 | Professional | 55 · Aftercare only | $380.19 | $436.52 | $478.63 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $2,754.23 Typical High $2,951.21 | Professional | 62 · Two surgeons | $2,398.83 | $2,754.23 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,570.88 Median $5,248.07 Typical High $5,754.40 | Professional | 63 · Small infant | $4,570.88 | $5,248.07 | $5,754.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $3,090.30 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,691.53 | $3,090.30 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $616.60 Median $707.95 Typical High $758.58 | Professional | 80 · Assistant surgeon | $616.60 | $707.95 | $758.58 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $616.60 Median $707.95 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $616.60 | $707.95 | $758.58 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $616.60 Median $707.95 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $616.60 | $707.95 | $758.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $602.56 Typical High $645.65 | Professional | AS · PA/NP assist | $524.81 | $602.56 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,479.11 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $588.84 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,187.76 | $4,168.69 | $4,168.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $436.52 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $295.12 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,041.74 | $3,890.45 | $3,890.45 |
Where Idaho sits
The same service costs 16.2 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· 11th of 51
$4,074
AK $9,772TX $603
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.