How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,089 to $14,125Professionalmedian $2,239 · 10th to 90th $1,445 to $3,162
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,412.54 | $3,162.28 | $3,162.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,754.40 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,454.71 | $2,570.40 |
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 $1,479.11 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,905.46 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $5,495.41 | Facility | None | $1,071.52 | $3,162.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,454.71 | $3,162.28 |
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 $1,862.09 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,862.09 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,238.72 | $2,754.23 |
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 $2,137.96 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,570.40 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $10,715.19 | Facility | None | $1,071.52 | $1,096.48 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,071.52 | $1,621.81 |
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 $1,230.27 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,778.28 | $2,691.53 |
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 $707.95 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $707.95 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $288.40 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,071.52 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $213.80 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $141.25 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,000.00 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,137.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,819.70 | $2,137.96 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,513.56 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,258.93 | $1,513.56 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,884.03 Typical High $3,019.95 | Professional | 63 · Small infant | $2,454.71 | $2,884.03 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $407.38 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $380.19 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $323.59 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $380.19 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $323.59 Typical High $346.74 | Professional | AS · PA/NP assist | $275.42 | $323.59 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $912.01 | $1,584.89 | $1,584.89 |
Moda Health 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 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,380.38 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $275.42 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $181.97 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,187.76 | $2,187.76 |
Where Idaho sits
The same service costs 6.6 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
$2,455
AK $5,248TX $794
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.