How much rates vary
Facilitymedian $1,622 · 10th to 90th $550 to $7,244Professionalmedian $3,388 · 10th to 90th $2,239 to $4,365
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 $2,290.87 Median $4,365.16 Typical High $4,365.16 | Professional | None | $2,290.87 | $4,365.16 | $4,365.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,606.93 Median $7,079.46 Typical High $8,511.38 | Facility | None | $6,606.93 | $7,079.46 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $3,801.89 | Professional | None | $3,090.30 | $3,630.78 | $3,801.89 |
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 $2,238.72 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,630.27 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $4,365.16 Typical High $6,165.95 | Facility | None | $1,621.81 | $4,365.16 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,801.89 Typical High $4,365.16 | Professional | None | $2,290.87 | $3,801.89 | $4,365.16 |
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 $2,754.23 Median $3,388.44 Typical High $3,388.44 | Facility | None | $2,754.23 | $3,388.44 | $3,388.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,265.80 | Professional | None | $3,388.44 | $3,388.44 | $4,265.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,801.89 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Facility | None | $1,621.81 | $1,621.81 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,621.81 | $2,290.87 |
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 $1,862.09 Median $2,754.23 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,754.23 | $4,073.80 |
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 $1,148.15 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,148.15 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $467.74 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,737.80 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $346.74 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $229.09 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,621.81 | $3,019.95 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,162.28 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,754.23 | $3,162.28 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $346.74 Typical High $380.19 | Professional | 55 · Aftercare only | $302.00 | $346.74 | $380.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,905.46 | $2,187.76 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,630.78 Median $4,168.69 Typical High $4,570.88 | Professional | 63 · Small infant | $3,630.78 | $4,168.69 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,454.71 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,454.71 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 80 · Assistant surgeon | $489.78 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $489.78 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $489.78 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $478.63 Typical High $512.86 | Professional | AS · PA/NP assist | $416.87 | $478.63 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,148.15 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $467.74 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,737.80 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $346.74 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $229.09 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,621.81 | $3,019.95 | $3,019.95 |
Where Idaho sits
The same service costs 5.9 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
$3,236
AK $7,762TX $1,318
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.