How much rates vary
Facilitymedian $1,862 · 10th to 90th $676 to $4,898Professionalmedian $4,169 · 10th to 90th $3,090 to $5,012
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,715.35 | $4,073.80 | $4,073.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $4,897.79 | Facility | None | $1,380.38 | $2,187.76 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,073.80 Median $4,365.16 Typical High $4,897.79 | Professional | None | $4,073.80 | $4,365.16 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $4,265.80 | Professional | None | $2,951.21 | $3,715.35 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $5,888.44 | Facility | None | $2,187.76 | $4,073.80 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,073.80 Typical High $5,128.61 | Professional | None | $3,890.45 | $4,073.80 | $5,128.61 |
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 $3,311.31 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,311.31 | $3,890.45 | $3,890.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,570.88 | Professional | None | $3,890.45 | $3,890.45 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,786.30 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,786.30 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,128.61 | Professional | None | $4,168.69 | $4,168.69 | $5,128.61 |
Select Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $3,890.45 | Facility | None | $2,187.76 | $2,238.72 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,388.44 | Professional | None | $2,187.76 | $2,187.76 | $3,388.44 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $4,677.35 | Professional | None | $2,570.40 | $3,467.37 | $4,677.35 |
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 $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,862.09 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,818.38 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $562.34 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $4,073.80 Typical High $4,570.88 | Professional | 54 · Surgery only | $3,630.78 | $4,073.80 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $512.86 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,511.89 Median $2,818.38 Typical High $3,162.28 | Professional | 62 · Two surgeons | $2,511.89 | $2,818.38 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,897.79 Median $5,370.32 Typical High $6,165.95 | Professional | 63 · Small infant | $4,897.79 | $5,370.32 | $6,165.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,162.28 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,162.28 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $724.44 Typical High $812.83 | Professional | 80 · Assistant surgeon | $645.65 | $724.44 | $812.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $645.65 Median $724.44 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $645.65 | $724.44 | $812.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $645.65 Median $724.44 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $645.65 | $724.44 | $812.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | AS · PA/NP assist | $549.54 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,862.09 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $741.31 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,818.38 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $562.34 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $371.54 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,884.03 | $2,884.03 |
Where Idaho sits
The same service costs 15.8 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
$4,074
AK $8,128TX $513
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.