How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,862 to $13,183Professionalmedian $1,905 · 10th to 90th $1,202 to $3,090
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 $3,715.35 Median $4,365.16 Typical High $8,511.38 | Facility | None | $3,715.35 | $4,365.16 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $3,090.30 Typical High $3,090.30 | Professional | None | $1,096.48 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $870.96 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $812.83 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,011.87 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,041.74 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,380.38 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,380.38 | $1,479.11 |
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 $1,230.27 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,513.56 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $3,715.35 Typical High $10,000.00 | Facility | None | $1,148.15 | $3,715.35 | $10,000.00 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,041.74 | $3,090.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,148.15 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,071.52 | $2,187.76 | $2,187.76 |
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 $1,513.56 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,513.56 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,862.09 | $1,862.09 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,819.70 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,819.70 | $2,137.96 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $10,715.19 | Facility | None | $891.25 | $912.01 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,995.26 | Professional | None | $891.25 | $891.25 | $1,995.26 |
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 $1,096.48 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,479.11 | $2,290.87 |
17 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 $575.44 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $575.44 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $229.09 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $173.78 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $114.82 | $309.03 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $199.53 | $208.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,089.30 Median $2,398.83 Typical High $2,511.89 | Professional | 63 · Small infant | $2,089.30 | $2,398.83 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 80 · Assistant surgeon | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $269.15 Typical High $281.84 | Professional | AS · PA/NP assist | $234.42 | $269.15 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $758.58 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $302.00 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $229.09 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $151.36 | $309.03 | $309.03 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 22 · Increased work | $2,290.87 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 63 · Small infant | $2,290.87 | $2,290.87 | $2,290.87 |
Where Idaho sits
The same service costs 6.2 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· 10th of 51
$1,995
AK $4,365TX $708
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.