How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $9,550Professionalmedian $4,266 · 10th to 90th $2,630 to $5,623
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 $2,691.53 Median $5,623.41 Typical High $5,623.41 | Professional | None | $2,691.53 | $5,623.41 | $5,623.41 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $11,220.18 | Facility | None | $8,709.64 | $9,332.54 | $11,220.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $4,786.30 | Professional | None | $3,890.45 | $4,570.88 | $4,786.30 |
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 $2,951.21 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,951.21 | $3,388.44 | $3,981.07 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,495.41 Typical High $8,128.31 | Facility | None | $1,862.09 | $5,495.41 | $8,128.31 |
Moda Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $5,623.41 | Professional | None | $3,162.28 | $4,365.16 | $5,623.41 |
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 $3,467.37 Median $4,265.80 Typical High $4,265.80 | Facility | None | $3,467.37 | $4,265.80 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,073.80 Median $4,677.35 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,677.35 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,187.76 | Facility | None | $1,995.26 | $1,995.26 | $2,187.76 |
Select Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,995.26 | $1,995.26 | $2,884.03 |
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 $2,238.72 Median $3,548.13 Typical High $5,128.61 | Professional | None | $2,238.72 | $3,548.13 | $5,128.61 |
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 $1,348.96 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,348.96 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $537.03 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,995.26 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $407.38 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $269.15 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,862.09 | $3,981.07 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,890.45 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,388.44 | $3,890.45 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $426.58 Typical High $478.63 | Professional | 55 · Aftercare only | $380.19 | $426.58 | $478.63 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $2,691.53 Typical High $2,951.21 | Professional | 62 · Two surgeons | $2,398.83 | $2,691.53 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,570.88 Median $5,128.61 Typical High $5,623.41 | Professional | 63 · Small infant | $4,570.88 | $5,128.61 | $5,623.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $3,019.95 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,630.27 | $3,019.95 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | 80 · Assistant surgeon | $602.56 | $676.08 | $758.58 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $602.56 | $676.08 | $758.58 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $602.56 | $676.08 | $758.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | AS · PA/NP assist | $512.86 | $575.44 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,584.89 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $630.96 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,344.23 | $4,265.80 | $4,265.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $467.74 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $316.23 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,187.76 | $3,981.07 | $3,981.07 |
Where Idaho sits
The same service costs 7.4 times more in Alaska than in Washington. 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.
Physician feeFacility fee
AK $20,770WA $2,820
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.