How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $8,318Professionalmedian $3,890 · 10th to 90th $2,570 to $5,012
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 $2,691.53 Median $5,011.87 Typical High $5,011.87 | Professional | None | $2,691.53 | $5,011.87 | $5,011.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,585.78 Median $8,128.31 Typical High $9,772.37 | Facility | None | $7,585.78 | $8,128.31 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,466.84 | Professional | None | $3,548.13 | $4,168.69 | $4,466.84 |
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 $2,570.40 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,570.40 | $3,090.30 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,862.09 | $5,011.87 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $5,011.87 | Professional | None | $2,691.53 | $4,265.80 | $5,011.87 |
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 $3,162.28 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,162.28 | $3,890.45 | $3,890.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,897.79 | Professional | None | $3,890.45 | $3,890.45 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,715.35 Median $4,466.84 Typical High $5,011.87 | Professional | None | $3,715.35 | $4,466.84 | $5,011.87 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Facility | None | $1,862.09 | $1,862.09 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,862.09 | $1,862.09 | $2,630.27 |
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 $2,137.96 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,137.96 | $3,162.28 | $4,677.35 |
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 $1,318.26 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,318.26 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $537.03 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,995.26 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $398.11 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $269.15 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,862.09 | $3,548.13 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,630.78 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,162.28 | $3,630.78 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $346.74 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $2,511.89 Typical High $2,691.53 | Professional | 62 · Two surgeons | $2,187.76 | $2,511.89 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,168.69 Median $4,786.30 Typical High $5,248.07 | Professional | 63 · Small infant | $4,168.69 | $4,786.30 | $5,248.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,818.38 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,818.38 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 80 · Assistant surgeon | $562.34 | $645.65 | $691.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $562.34 | $645.65 | $691.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $562.34 | $645.65 | $691.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $537.03 Typical High $588.84 | Professional | AS · PA/NP assist | $467.74 | $537.03 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,318.26 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $537.03 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,995.26 | $3,801.89 | $3,801.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $398.11 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $269.15 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,862.09 | $3,548.13 | $3,548.13 |
Where Idaho sits
The same service costs 7.2 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
$3,715
AK $8,913TX $1,230
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.