How much rates vary
Facilitymedian $1,413 · 10th to 90th $550 to $7,244Professionalmedian $2,754 · 10th to 90th $1,950 to $3,236
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 $1,819.70 Median $3,090.30 Typical High $3,090.30 | Professional | None | $1,819.70 | $3,090.30 | $3,090.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,606.93 Median $6,918.31 Typical High $8,511.38 | Facility | None | $6,606.93 | $6,918.31 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,691.53 | $2,884.03 | $3,311.31 |
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 $2,187.76 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,511.89 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $3,090.30 Typical High $5,495.41 | Facility | None | $1,412.54 | $3,090.30 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,290.87 | $2,951.21 | $3,090.30 |
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 $2,398.83 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,398.83 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $3,162.28 | Professional | None | $2,570.40 | $2,754.23 | $3,162.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,691.53 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Facility | None | $1,412.54 | $1,412.54 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,412.54 | $2,238.72 |
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 $1,778.28 Median $2,570.40 Typical High $3,715.35 | Professional | None | $1,778.28 | $2,570.40 | $3,715.35 |
22 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 $912.01 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $912.01 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $363.08 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,348.96 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $269.15 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $181.97 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,258.93 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $4,677.35 Typical High $5,011.87 | Professional | 50 · Both sides | $3,981.07 | $4,677.35 | $5,011.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,818.38 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,398.83 | $2,818.38 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $263.03 | $316.23 | $331.13 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,949.84 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,659.59 | $1,949.84 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,162.28 Median $3,801.89 Typical High $3,981.07 | Professional | 63 · Small infant | $3,162.28 | $3,801.89 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,187.76 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,187.76 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $501.19 Typical High $524.81 | Professional | 80 · Assistant surgeon | $426.58 | $501.19 | $524.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $426.58 Median $501.19 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $426.58 | $501.19 | $524.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $426.58 Median $501.19 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $426.58 | $501.19 | $524.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | AS · PA/NP assist | $363.08 | $426.58 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,148.15 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $457.09 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,698.24 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $338.84 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $229.09 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,187.76 | $2,187.76 |
Where Idaho sits
The same service costs 21.9 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· 13th of 51
$2,692
AK $7,079TX $324
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.