How much rates vary
Facilitymedian $1,288 · 10th to 90th $550 to $6,166Professionalmedian $2,692 · 10th to 90th $1,698 to $4,365
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 $1,698.24 Median $4,365.16 Typical High $4,365.16 | Professional | None | $1,698.24 | $4,365.16 | $4,365.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,495.41 Median $5,754.40 Typical High $6,918.31 | Facility | None | $5,495.41 | $5,754.40 | $6,918.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,884.03 | $3,019.95 |
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 $1,819.70 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,137.96 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $4,365.16 Typical High $6,309.57 | Facility | None | $1,288.25 | $4,365.16 | $6,309.57 |
Moda Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,041.74 | $2,884.03 | $4,365.16 |
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 $2,187.76 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,187.76 | $2,691.53 | $2,691.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,884.03 | Professional | None | $2,691.53 | $2,691.53 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,570.40 | $3,019.95 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Facility | None | $1,288.25 | $1,288.25 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,288.25 | $2,818.38 |
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 $1,659.59 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,659.59 | $2,137.96 | $3,235.94 |
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 $851.14 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $851.14 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $346.74 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,288.25 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $257.04 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $169.82 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,202.26 | $3,090.30 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,570.40 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,238.72 | $2,570.40 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $288.40 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $288.40 | $302.00 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,778.28 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,548.82 | $1,778.28 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,951.21 Median $3,388.44 Typical High $3,630.78 | Professional | 63 · Small infant | $2,951.21 | $3,388.44 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,995.26 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,995.26 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $457.09 Typical High $478.63 | Professional | 80 · Assistant surgeon | $398.11 | $457.09 | $478.63 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $457.09 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $398.11 | $457.09 | $478.63 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $457.09 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $457.09 | $478.63 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | AS · PA/NP assist | $338.84 | $389.05 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,023.29 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $407.38 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,548.82 | $3,311.31 | $3,311.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $309.03 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $204.17 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,445.44 | $3,090.30 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 22 · Increased work | $3,162.28 | $3,162.28 | $3,162.28 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,819.70 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 63 · Small infant | $3,162.28 | $3,162.28 | $3,162.28 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,187.76 |
Where Idaho sits
The same service costs 20.9 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
$2,692
AK $5,129TX $245
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.