How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $2,818Professionalmedian $1,259 · 10th to 90th $741 to $1,950
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 $724.44 Median $1,949.84 Typical High $1,949.84 | Professional | None | $724.44 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $2,818.38 | Facility | None | $1,659.59 | $2,344.23 | $2,818.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,348.96 | $1,412.54 |
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 $776.25 Median $933.25 Typical High $1,096.48 | Professional | None | $776.25 | $933.25 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $4,466.84 | Facility | None | $602.56 | $1,949.84 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,949.84 | Professional | None | $933.25 | $1,258.93 | $1,949.84 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,258.93 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,348.96 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $645.65 | Facility | None | $602.56 | $602.56 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,230.27 | Professional | None | $602.56 | $602.56 | $1,230.27 |
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 $660.69 Median $870.96 Typical High $1,318.26 | Professional | None | $660.69 | $870.96 | $1,318.26 |
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 $363.08 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $363.08 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $144.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $537.03 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $107.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $72.44 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $501.19 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $141.25 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 62 · Two surgeons | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 63 · Small infant | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $467.74 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $186.21 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $691.83 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $138.04 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $93.33 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $645.65 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 22 · Increased work | $1,412.54 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 62 · Two surgeons | $794.33 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 63 · Small infant | $1,412.54 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Where Idaho sits
The same service costs 5.4 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· 8th of 51
$1,259
AK $2,512TX $468
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.