How much rates vary
Facilitymedian $1,175 · 10th to 90th $550 to $5,623Professionalmedian $2,512 · 10th to 90th $1,549 to $3,981
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 $1,584.89 Median $3,981.07 Typical High $3,981.07 | Professional | None | $1,584.89 | $3,981.07 | $3,981.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,011.87 Median $5,370.32 Typical High $6,456.54 | Facility | None | $5,011.87 | $5,370.32 | $6,456.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,630.27 | $2,818.38 |
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 $1,659.59 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,995.26 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $3,981.07 Typical High $5,754.40 | Facility | None | $1,174.90 | $3,981.07 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,630.27 | $3,981.07 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,630.27 | Professional | None | $2,454.71 | $2,454.71 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,818.38 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Facility | None | $1,174.90 | $1,174.90 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,174.90 | $2,570.40 |
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 $1,513.56 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,949.84 | $2,951.21 |
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 $794.33 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $794.33 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $316.23 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,174.90 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $234.42 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $158.49 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,096.48 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,344.23 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,041.74 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $263.03 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,621.81 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,412.54 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,162.28 Typical High $3,311.31 | Professional | 63 · Small infant | $2,754.23 | $3,162.28 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,819.70 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,819.70 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 80 · Assistant surgeon | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $354.81 Typical High $371.54 | Professional | AS · PA/NP assist | $309.03 | $354.81 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $954.99 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $380.19 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,412.54 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $281.84 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $190.55 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 22 · Increased work | $2,951.21 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,659.59 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 63 · Small infant | $2,951.21 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 5.5 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
$2,455
AK $4,898TX $891
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.