How much rates vary
Facilitymedian $1,995 · 10th to 90th $550 to $11,482Professionalmedian $5,129 · 10th to 90th $3,162 to $8,128
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 $3,235.94 Median $8,128.31 Typical High $8,128.31 | Professional | None | $3,235.94 | $8,128.31 | $8,128.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $10,232.93 Median $10,964.78 Typical High $13,182.57 | Facility | None | $10,232.93 | $10,964.78 | $13,182.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,677.35 Median $5,370.32 Typical High $5,623.41 | Professional | None | $4,677.35 | $5,370.32 | $5,623.41 |
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 $3,388.44 Median $3,981.07 Typical High $4,677.35 | Professional | None | $3,388.44 | $3,981.07 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,995.26 | $5,495.41 | $11,481.54 |
Moda Health Setting Professional Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $8,128.31 | Professional | None | $3,801.89 | $5,248.07 | $8,128.31 |
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 $4,073.80 Median $5,011.87 Typical High $5,011.87 | Facility | None | $4,073.80 | $5,011.87 | $5,011.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,370.32 | Professional | None | $5,011.87 | $5,011.87 | $5,370.32 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $5,623.41 | Professional | None | $4,786.30 | $5,623.41 | $5,623.41 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,630.27 | Facility | None | $2,398.83 | $2,398.83 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $5,128.61 | Professional | None | $2,398.83 | $2,398.83 | $5,128.61 |
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 $3,090.30 Median $3,981.07 Typical High $6,165.95 | Professional | None | $3,090.30 | $3,981.07 | $6,165.95 |
27 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 $1,621.81 Median $4,073.80 Typical High $4,073.80 | Professional | 52 · Reduced service | $1,621.81 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $1,621.81 Typical High $1,621.81 | Professional | 53 · Discontinued | $645.65 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $6,025.60 Typical High $6,025.60 | Professional | 54 · Surgery only | $2,398.83 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $478.63 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $812.83 Typical High $812.83 | Professional | 56 · Pre-op care only | $323.59 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $5,623.41 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $2,238.72 | $5,623.41 | $5,623.41 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $4,168.69 Median $4,786.30 Typical High $5,128.61 | Professional | 54 · Surgery only | $4,168.69 | $4,786.30 | $5,128.61 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $537.03 Typical High $562.34 | Professional | 55 · Aftercare only | $467.74 | $537.03 | $562.34 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,884.03 Median $3,311.31 Typical High $3,548.13 | Professional | 62 · Two surgeons | $2,884.03 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,623.41 Median $6,456.54 Typical High $6,760.83 | Professional | 63 · Small infant | $5,623.41 | $6,456.54 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,715.35 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,715.35 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | 80 · Assistant surgeon | $741.31 | $851.14 | $912.01 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $741.31 | $851.14 | $912.01 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $741.31 | $851.14 | $912.01 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $630.96 Median $724.44 Typical High $776.25 | Professional | AS · PA/NP assist | $630.96 | $724.44 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,905.46 Median $4,073.80 Typical High $4,073.80 | Professional | 52 · Reduced service | $1,905.46 | $4,073.80 | $4,073.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $1,621.81 Typical High $1,621.81 | Professional | 53 · Discontinued | $758.58 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $6,025.60 Typical High $6,025.60 | Professional | 54 · Surgery only | $2,818.38 | $6,025.60 | $6,025.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $562.34 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $812.83 Typical High $812.83 | Professional | 56 · Pre-op care only | $380.19 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $5,623.41 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $2,630.27 | $5,623.41 | $5,623.41 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | 22 · Increased work | $5,888.44 | $5,888.44 | $5,888.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,715.35 | $3,715.35 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $537.03 | $537.03 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 62 · Two surgeons | $3,311.31 | $3,311.31 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | 63 · Small infant | $5,888.44 | $5,888.44 | $5,888.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,981.07 | $3,981.07 | $3,981.07 |
Where Idaho sits
The same service costs 5.1 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
$5,129
AK $9,772TX $1,905
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.