How much rates vary
Facilitymedian $1,175 · 10th to 90th $550 to $5,623Professionalmedian $2,512 · 10th to 90th $1,585 to $4,074
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 $4,073.80 Typical High $4,073.80 | Professional | None | $1,584.89 | $4,073.80 | $4,073.80 |
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 $2,691.53 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,691.53 | $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 $1,698.24 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,995.26 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,174.90 | $4,073.80 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,630.27 | $4,073.80 |
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 $2,041.74 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,041.74 | $2,511.89 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,691.53 | Professional | None | $2,511.89 | $2,511.89 | $2,691.53 |
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 $1,288.25 | Facility | None | $1,174.90 | $1,174.90 | $1,288.25 |
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 $1,995.26 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,995.26 | $3,019.95 |
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 $794.33 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $794.33 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $323.59 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,202.26 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $239.88 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $158.49 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,398.83 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,089.30 | $2,398.83 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $263.03 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,659.59 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,445.44 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,754.23 Median $3,162.28 Typical High $3,388.44 | Professional | 63 · Small infant | $2,754.23 | $3,162.28 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,862.09 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $426.58 Typical High $446.68 | Professional | 80 · Assistant surgeon | $371.54 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $426.58 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $371.54 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $426.58 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $363.08 Typical High $380.19 | Professional | AS · PA/NP assist | $316.23 | $363.08 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $954.99 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $380.19 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,445.44 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $288.40 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $190.55 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,348.96 | $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 $269.15 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $269.15 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,698.24 | $1,698.24 | $1,698.24 |
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 5.2 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
$2,512
AK $4,898TX $933
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.