How much rates vary
Facilitymedian $1,549 · 10th to 90th $1,047 to $4,898Professionalmedian $3,090 · 10th to 90th $2,188 to $3,890
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 $2,238.72 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,238.72 | $3,630.78 | $3,630.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,511.89 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $3,548.13 | Professional | None | $2,818.38 | $3,235.94 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,454.71 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,630.78 Typical High $5,495.41 | Facility | None | $1,445.44 | $3,630.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,630.78 Typical High $4,168.69 | Professional | None | $2,238.72 | $3,630.78 | $4,168.69 |
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 $2,511.89 Median $3,090.30 Typical High $3,090.30 | Facility | None | $2,511.89 | $3,090.30 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,890.45 | Professional | None | $3,090.30 | $3,090.30 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $4,168.69 | Professional | None | $3,019.95 | $3,548.13 | $4,168.69 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $6,309.57 | Facility | None | $1,445.44 | $1,479.11 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,691.53 | Professional | None | $977.24 | $1,445.44 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,630.27 | $3,801.89 |
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 $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,122.02 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $446.68 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,698.24 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $338.84 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $223.87 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,818.38 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,570.40 | $2,818.38 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $316.23 | $346.74 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $1,995.26 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,778.28 | $1,995.26 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,388.44 Median $3,801.89 Typical High $4,168.69 | Professional | 63 · Small infant | $3,388.44 | $3,801.89 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 80 · Assistant surgeon | $457.09 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $457.09 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | AS · PA/NP assist | $389.05 | $426.58 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,122.02 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $446.68 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,698.24 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $338.84 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $223.87 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,511.89 | $2,511.89 |
Where Idaho sits
The same service costs 21.4 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
$3,090
AK $7,244TX $339
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.