How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,995 to $15,849Professionalmedian $2,512 · 10th to 90th $1,778 to $3,467
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 $1,778.28 Median $3,467.37 Typical High $3,467.37 | Professional | None | $1,778.28 | $3,467.37 | $3,467.37 |
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 $2,290.87 Median $2,691.53 Typical High $2,884.03 | Professional | None | $2,290.87 | $2,691.53 | $2,884.03 |
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 $1,778.28 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,949.84 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $5,495.41 | Facility | None | $1,445.44 | $3,467.37 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,388.44 Typical High $3,467.37 | Professional | None | $1,778.28 | $3,388.44 | $3,467.37 |
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 $3,467.37 | Professional | None | $2,454.71 | $2,454.71 | $3,467.37 |
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 $2,691.53 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,691.53 | $2,884.03 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $9,332.54 | Facility | None | $1,174.90 | $1,202.26 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $4,677.35 | Professional | None | $1,174.90 | $1,412.54 | $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 $1,584.89 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,137.96 | $3,090.30 |
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 $891.25 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $891.25 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $354.81 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,348.96 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $269.15 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $177.83 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,258.93 | $2,398.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,344.23 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,344.23 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $263.03 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,621.81 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,412.54 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,162.28 Typical High $3,311.31 | Professional | 63 · Small infant | $2,754.23 | $3,162.28 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,819.70 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,819.70 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 80 · Assistant surgeon | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $354.81 Typical High $371.54 | Professional | AS · PA/NP assist | $309.03 | $354.81 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $891.25 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $354.81 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,348.96 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $269.15 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $177.83 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,258.93 | $2,398.83 | $2,398.83 |
Where Idaho sits
The same service costs 24.5 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· 10th of 51
$2,630
AK $5,754TX $234
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.