How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $15,488Professionalmedian $7,413 · 10th to 90th $4,677 to $12,023
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 $4,570.88 Median $12,022.64 Typical High $12,022.64 | Professional | None | $4,570.88 | $12,022.64 | $12,022.64 |
BCBS Idaho Setting Facility Modifier None Typical Low $14,125.38 Median $15,135.61 Typical High $18,197.01 | Facility | None | $14,125.38 | $15,135.61 | $18,197.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $6,760.83 Median $7,943.28 Typical High $8,511.38 | Professional | None | $6,760.83 | $7,943.28 | $8,511.38 |
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 $4,897.79 Median $5,888.44 Typical High $6,918.31 | Professional | None | $4,897.79 | $5,888.44 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $5,495.41 Typical High $12,022.64 | Facility | None | $1,348.96 | $5,495.41 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $5,754.40 Median $7,943.28 Typical High $12,022.64 | Professional | None | $5,754.40 | $7,943.28 | $12,022.64 |
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 $6,025.60 Median $7,413.10 Typical High $7,413.10 | Facility | None | $6,025.60 | $7,413.10 | $7,413.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,943.28 | Professional | None | $7,413.10 | $7,413.10 | $7,943.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,079.46 Median $8,511.38 Typical High $8,511.38 | Professional | None | $7,079.46 | $8,511.38 | $8,511.38 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,801.89 | Facility | None | $3,548.13 | $3,548.13 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $7,762.47 | Professional | None | $3,548.13 | $3,548.13 | $7,762.47 |
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 $4,168.69 Median $5,495.41 Typical High $8,317.64 | Professional | None | $4,168.69 | $5,495.41 | $8,317.64 |
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 $2,290.87 Median $6,025.60 Typical High $6,025.60 | Professional | 52 · Reduced service | $2,290.87 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $2,398.83 Typical High $2,398.83 | Professional | 53 · Discontinued | $912.01 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $3,388.44 | $9,120.11 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $676.08 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $1,202.26 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $457.09 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $3,162.28 | $8,511.38 | $8,511.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $6,165.95 Median $7,079.46 Typical High $7,413.10 | Professional | 54 · Surgery only | $6,165.95 | $7,079.46 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $794.33 Typical High $831.76 | Professional | 55 · Aftercare only | $676.08 | $794.33 | $831.76 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $4,265.80 Median $4,897.79 Typical High $5,128.61 | Professional | 62 · Two surgeons | $4,265.80 | $4,897.79 | $5,128.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $8,128.31 Median $9,332.54 Typical High $10,000.00 | Professional | 63 · Small infant | $8,128.31 | $9,332.54 | $10,000.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,786.30 Median $5,495.41 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $4,786.30 | $5,495.41 | $5,754.40 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,096.48 Median $1,258.93 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $1,096.48 | $1,258.93 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,096.48 Median $1,258.93 Typical High $1,318.26 | Professional | 81 · Minimal assistant surgeon | $1,096.48 | $1,258.93 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,096.48 Median $1,258.93 Typical High $1,318.26 | Professional | 82 · Assistant surgeon, no resident | $1,096.48 | $1,258.93 | $1,318.26 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $933.25 Median $1,071.52 Typical High $1,122.02 | Professional | AS · PA/NP assist | $933.25 | $1,071.52 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,818.38 Median $6,025.60 Typical High $6,025.60 | Professional | 52 · Reduced service | $2,818.38 | $6,025.60 | $6,025.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $2,398.83 Typical High $2,398.83 | Professional | 53 · Discontinued | $1,148.15 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,265.80 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $4,265.80 | $9,120.11 | $9,120.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $851.14 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $1,202.26 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $575.44 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,981.07 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $3,981.07 | $8,511.38 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | 22 · Increased work | $8,709.64 | $8,709.64 | $8,709.64 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | 54 · Surgery only | $5,623.41 | $5,623.41 | $5,623.41 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 56 · Pre-op care only | $794.33 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | 62 · Two surgeons | $5,011.87 | $5,011.87 | $5,011.87 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | 63 · Small infant | $8,709.64 | $8,709.64 | $8,709.64 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $6,025.60 | $6,025.60 | $6,025.60 |
Where Idaho sits
The same service costs 21.9 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
$7,413
AK $14,125TX $646
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.