How much rates vary
Facilitymedian $1,585 · 10th to 90th $550 to $7,943Professionalmedian $3,388 · 10th to 90th $2,188 to $4,786
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 $2,137.96 Median $4,786.30 Typical High $4,786.30 | Professional | None | $2,137.96 | $4,786.30 | $4,786.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,079.46 Median $7,585.78 Typical High $9,120.11 | Facility | None | $7,079.46 | $7,585.78 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $3,890.45 | Professional | None | $3,090.30 | $3,630.78 | $3,890.45 |
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 $2,344.23 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,818.38 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $4,466.84 Typical High $5,495.41 | Facility | None | $1,174.90 | $4,466.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $4,786.30 | Professional | None | $2,754.23 | $3,467.37 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $3,388.44 | Facility | None | $2,754.23 | $3,388.44 | $3,388.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,630.78 | Professional | None | $3,388.44 | $3,388.44 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $3,981.07 | Professional | None | $3,235.94 | $3,890.45 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,584.89 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,584.89 | $1,584.89 | $2,454.71 |
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 $1,905.46 Median $2,884.03 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,884.03 | $4,168.69 |
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 $1,071.52 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,071.52 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $426.58 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,621.81 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $323.59 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $213.80 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,513.56 | $3,311.31 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,235.94 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,691.53 | $3,235.94 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | 55 · Aftercare only | $302.00 | $354.81 | $380.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,238.72 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,905.46 | $2,238.72 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,630.78 Median $4,265.80 Typical High $4,466.84 | Professional | 63 · Small infant | $3,630.78 | $4,265.80 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,511.89 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $575.44 Typical High $602.56 | Professional | 80 · Assistant surgeon | $478.63 | $575.44 | $602.56 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $575.44 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $478.63 | $575.44 | $602.56 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $575.44 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $575.44 | $602.56 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $489.78 Typical High $512.86 | Professional | AS · PA/NP assist | $407.38 | $489.78 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,348.96 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $549.54 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,041.74 | $3,548.13 | $3,548.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $407.38 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $275.42 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,905.46 | $3,311.31 | $3,311.31 |
Where Idaho sits
The same service costs 7.8 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· 13th of 51
$3,311
AK $7,762TX $1,000
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.