How much rates vary
Facilitymedian $1,175 · 10th to 90th $550 to $5,370Professionalmedian $2,455 · 10th to 90th $1,585 to $3,162
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 $1,659.59 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,659.59 | $3,162.28 | $3,162.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,677.35 Median $5,011.87 Typical High $6,025.60 | Facility | None | $4,677.35 | $5,011.87 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,691.53 | $2,754.23 |
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 $1,621.81 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,905.46 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,162.28 Typical High $5,495.41 | Facility | None | $1,174.90 | $3,162.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,691.53 | $3,162.28 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,454.71 | $2,454.71 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,090.30 | Professional | None | $2,290.87 | $2,754.23 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Facility | None | $1,174.90 | $1,174.90 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,174.90 | $1,659.59 |
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 $1,318.26 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,949.84 | $2,884.03 |
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 $831.76 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $831.76 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $331.13 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,258.93 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $251.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $165.96 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,174.90 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,290.87 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,995.26 | $2,290.87 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,584.89 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,380.38 | $1,584.89 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,090.30 Typical High $3,311.31 | Professional | 63 · Small infant | $2,691.53 | $3,090.30 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,778.28 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,778.28 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $407.38 Typical High $446.68 | Professional | 80 · Assistant surgeon | $354.81 | $407.38 | $446.68 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $407.38 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $354.81 | $407.38 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $407.38 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $407.38 | $446.68 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $346.74 Typical High $380.19 | Professional | AS · PA/NP assist | $302.00 | $346.74 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $831.76 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $331.13 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,258.93 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $251.19 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $165.96 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,174.90 | $2,187.76 | $2,187.76 |
Where Idaho sits
The same service costs 5.8 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
$2,344
AK $5,623TX $977
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.