How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,995 to $15,849Professionalmedian $2,344 · 10th to 90th $1,660 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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
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 $2,754.23 Median $4,365.16 Typical High $17,378.01 | Facility | None | $2,754.23 | $4,365.16 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,454.71 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $4,570.88 Median $5,128.61 Typical High $6,918.31 | Facility | None | $4,570.88 | $5,128.61 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,819.70 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $3,162.28 Typical High $5,495.41 | Facility | None | $1,348.96 | $3,162.28 | $5,495.41 |
Moda Health 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 |
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 $1,862.09 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,862.09 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,290.87 | $3,235.94 |
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 $2,454.71 Median $2,630.27 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,630.27 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $9,332.54 | Facility | None | $1,096.48 | $1,096.48 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $4,677.35 | Professional | None | $1,096.48 | $1,318.26 | $4,677.35 |
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 $1,445.44 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,995.26 | $2,691.53 |
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 $1,230.27 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,230.27 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $251.19 | $478.63 | $478.63 |
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 $1,148.15 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,148.15 | $2,238.72 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,187.76 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,905.46 | $2,187.76 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $245.47 | $257.04 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,513.56 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,318.26 | $1,513.56 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 63 · Small infant | $2,511.89 | $2,884.03 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,698.24 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 80 · Assistant surgeon | $338.84 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $338.84 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $389.05 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $331.13 Typical High $346.74 | Professional | AS · PA/NP assist | $288.40 | $331.13 | $346.74 |
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 $1,230.27 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,230.27 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $251.19 | $478.63 | $478.63 |
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 $1,148.15 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,148.15 | $2,238.72 | $2,238.72 |
Where Idaho sits
The same service costs 11.0 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
$2,455
AK $5,370TX $490
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.