How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,820 to $15,849Professionalmedian $1,905 · 10th to 90th $1,288 to $2,512
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,318.26 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,754.23 Median $6,456.54 Typical High $17,378.01 | Facility | None | $2,754.23 | $6,456.54 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,698.24 | $1,995.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $8,128.31 Typical High $10,964.78 | Facility | None | $7,244.36 | $8,128.31 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,445.44 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $5,495.41 | Facility | None | $1,096.48 | $2,511.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,318.26 | $2,511.89 | $2,511.89 |
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 $1,479.11 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,479.11 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,819.70 | $2,570.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,964.78 Median $15,848.93 Typical High $21,877.62 | Facility | None | $10,964.78 | $15,848.93 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,949.84 | $2,089.30 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $891.25 Typical High $9,332.54 | Facility | None | $870.96 | $891.25 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $7,413.10 | Professional | None | $870.96 | $1,047.13 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,584.89 | $2,137.96 |
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 $660.69 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $660.69 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $263.03 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,000.00 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $199.53 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $131.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $933.25 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,737.80 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,737.80 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $204.17 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | 62 · Two surgeons | $1,047.13 | $1,230.27 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,041.74 Median $2,344.23 Typical High $2,454.71 | Professional | 63 · Small infant | $2,041.74 | $2,344.23 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $309.03 Typical High $331.13 | Professional | 80 · Assistant surgeon | $269.15 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $309.03 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $269.15 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $309.03 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $309.03 | $331.13 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $263.03 Typical High $275.42 | Professional | AS · PA/NP assist | $229.09 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $660.69 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $263.03 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,000.00 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $199.53 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $131.83 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $933.25 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 10th of 51
$1,950
AK $4,266UT $692
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.