How much rates vary
Facilitymedian $3,981 · 10th to 90th $2,089 to $14,125Professionalmedian $2,455 · 10th to 90th $1,738 to $3,020
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 $1,778.28 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,630.27 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,905.46 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,818.38 Typical High $4,466.84 | Facility | None | $1,148.15 | $2,818.38 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,818.38 | $3,235.94 |
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 $1,949.84 Median $2,398.83 Typical High $2,398.83 | Facility | None | $1,949.84 | $2,398.83 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,019.95 | Professional | None | $2,398.83 | $2,398.83 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,754.23 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $10,471.29 | Facility | None | $1,148.15 | $1,174.90 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,348.96 | $3,388.44 |
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 $1,348.96 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,949.84 | $2,818.38 |
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 $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $891.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $354.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,348.96 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,238.72 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,995.26 | $2,238.72 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,019.95 Typical High $3,235.94 | Professional | 63 · Small infant | $2,691.53 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,737.80 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,737.80 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 80 · Assistant surgeon | $354.81 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $354.81 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | AS · PA/NP assist | $302.00 | $338.84 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $891.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $354.81 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,348.96 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $269.15 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $177.83 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,949.84 | $1,949.84 |
Where Idaho sits
The same service costs 17.0 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· 9th of 51
$2,512
AK $5,495TX $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.