How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,995 to $15,849Professionalmedian $2,455 · 10th to 90th $1,698 to $3,311
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 $1,698.24 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,698.24 | $3,311.31 | $3,311.31 |
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 $2,187.76 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,570.40 | $2,754.23 |
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 $1,698.24 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,905.46 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $1,479.11 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,479.11 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $3,311.31 | Professional | None | $1,698.24 | $3,235.94 | $3,311.31 |
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 $1,905.46 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,905.46 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,344.23 | $3,311.31 |
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 $2,570.40 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,570.40 | $2,754.23 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $9,332.54 | Facility | None | $1,122.02 | $1,148.15 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $4,677.35 | Professional | None | $1,122.02 | $1,348.96 | $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 $1,513.56 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,041.74 | $2,754.23 |
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 $851.14 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $851.14 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $346.74 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,288.25 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $257.04 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $169.82 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,202.26 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,290.87 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,949.84 | $2,290.87 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,584.89 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,380.38 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,630.27 Median $3,019.95 Typical High $3,162.28 | Professional | 63 · Small infant | $2,630.27 | $3,019.95 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,778.28 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $407.38 Typical High $426.58 | Professional | 80 · Assistant surgeon | $346.74 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $407.38 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $346.74 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $407.38 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $338.84 Typical High $363.08 | Professional | AS · PA/NP assist | $295.12 | $338.84 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $851.14 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $346.74 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,288.25 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $257.04 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $169.82 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,202.26 | $2,290.87 | $2,290.87 |
Where Idaho sits
The same service costs 7.2 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
$2,512
AK $5,495TX $759
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.