How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $9,550Professionalmedian $4,365 · 10th to 90th $2,754 to $5,754
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 $2,570.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $2,570.40 | $5,754.40 | $5,754.40 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,317.64 Median $9,120.11 Typical High $10,715.19 | Facility | None | $8,317.64 | $9,120.11 | $10,715.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,128.61 | Professional | None | $4,073.80 | $4,786.30 | $5,128.61 |
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 $2,951.21 Median $3,548.13 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,548.13 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,466.84 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $3,019.95 Median $4,786.30 Typical High $5,754.40 | Professional | None | $3,019.95 | $4,786.30 | $5,754.40 |
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 $3,548.13 Median $4,365.16 Typical High $4,365.16 | Facility | None | $3,548.13 | $4,365.16 | $4,365.16 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,495.41 | Professional | None | $4,365.16 | $4,365.16 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,265.80 Median $5,128.61 Typical High $5,754.40 | Professional | None | $4,265.80 | $5,128.61 | $5,754.40 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,344.23 | Facility | None | $2,089.30 | $2,089.30 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,089.30 | $3,019.95 |
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 $3,548.13 Typical High $5,370.32 | Professional | None | $2,344.23 | $3,548.13 | $5,370.32 |
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 $1,288.25 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,288.25 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $512.86 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,905.46 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $380.19 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $257.04 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,778.28 | $4,073.80 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $4,073.80 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,548.13 | $4,073.80 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 55 · Aftercare only | $398.11 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,454.71 Median $2,818.38 Typical High $3,090.30 | Professional | 62 · Two surgeons | $2,454.71 | $2,818.38 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,786.30 Median $5,370.32 Typical High $5,888.44 | Professional | 63 · Small infant | $4,786.30 | $5,370.32 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,162.28 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,162.28 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | 80 · Assistant surgeon | $630.96 | $724.44 | $794.33 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $630.96 | $724.44 | $794.33 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $630.96 | $724.44 | $794.33 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $616.60 Typical High $676.08 | Professional | AS · PA/NP assist | $537.03 | $616.60 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,513.56 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,513.56 | $2,884.03 | $2,884.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $616.60 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,290.87 | $4,365.16 | $4,365.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $457.09 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $302.00 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,137.96 | $4,073.80 | $4,073.80 |
Where Idaho sits
The same service costs 10.0 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
$4,266
AK $10,233TX $1,023
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.