How much rates vary
Facilitymedian $1,445 · 10th to 90th $550 to $6,918Professionalmedian $3,090 · 10th to 90th $1,905 to $5,012
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 $5,011.87 Typical High $5,011.87 | Professional | None | $1,698.24 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,445.44 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,348.96 | $3,467.37 | $3,467.37 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,165.95 Median $6,606.93 Typical High $7,943.28 | Facility | None | $6,165.95 | $6,606.93 | $7,943.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $3,467.37 | Professional | None | $2,818.38 | $3,311.31 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,951.21 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,511.89 | $2,951.21 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,290.87 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,290.87 | $2,398.83 |
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 $2,089.30 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,454.71 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $7,079.46 | Facility | None | $1,445.44 | $5,011.87 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,235.94 Typical High $5,011.87 | Professional | None | $2,344.23 | $3,235.94 | $5,011.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,778.28 | $3,715.35 | $3,715.35 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,659.59 | $3,467.37 | $3,467.37 |
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 $2,454.71 Median $3,019.95 Typical High $3,019.95 | Facility | None | $2,454.71 | $3,019.95 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,019.95 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,454.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,951.21 | $3,467.37 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Facility | None | $1,445.44 | $1,445.44 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,445.44 | $3,162.28 |
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 $1,862.09 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,398.83 | $3,715.35 |
17 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 $977.24 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $977.24 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $389.05 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $288.40 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $194.98 | $501.19 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $323.59 Typical High $338.84 | Professional | 55 · Aftercare only | $281.84 | $323.59 | $338.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,388.44 Median $3,890.45 Typical High $4,073.80 | Professional | 63 · Small infant | $3,388.44 | $3,890.45 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $524.81 Typical High $549.54 | Professional | 80 · Assistant surgeon | $446.68 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $446.68 Median $524.81 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $446.68 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $446.68 Median $524.81 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $446.68 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $446.68 Typical High $467.74 | Professional | AS · PA/NP assist | $380.19 | $446.68 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,174.90 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $467.74 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $354.81 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $234.42 | $501.19 | $501.19 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 22 · Increased work | $3,630.78 | $3,630.78 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 63 · Small infant | $3,630.78 | $3,630.78 | $3,630.78 |
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· 10th of 51
$3,090
AK $6,026TX $1,122
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.