How much rates vary
Facilitymedian $1,905 · 10th to 90th $550 to $9,333Professionalmedian $4,074 · 10th to 90th $2,570 to $6,607
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 $2,570.40 Median $6,606.93 Typical High $6,606.93 | Professional | None | $2,570.40 | $6,606.93 | $6,606.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,317.64 Median $8,709.64 Typical High $10,715.19 | Facility | None | $8,317.64 | $8,709.64 | $10,715.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,715.35 Median $4,365.16 Typical High $4,570.88 | Professional | None | $3,715.35 | $4,365.16 | $4,570.88 |
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 $2,754.23 Median $3,235.94 Typical High $3,801.89 | Professional | None | $2,754.23 | $3,235.94 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,905.46 | $5,495.41 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,265.80 Typical High $6,606.93 | Professional | None | $3,090.30 | $4,265.80 | $6,606.93 |
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 $3,235.94 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,235.94 | $3,981.07 | $3,981.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,365.16 | Professional | None | $3,981.07 | $3,981.07 | $4,365.16 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,890.45 | $4,570.88 | $4,570.88 |
Select Health Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,041.74 | Facility | None | $1,905.46 | $1,905.46 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $4,168.69 | Professional | None | $1,905.46 | $1,905.46 | $4,168.69 |
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 $2,511.89 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,511.89 | $3,162.28 | $4,897.79 |
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 $1,288.25 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $1,288.25 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $524.81 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,949.84 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $389.05 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $257.04 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,819.70 | $4,570.88 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,801.89 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,311.31 | $3,801.89 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $426.58 Typical High $446.68 | Professional | 55 · Aftercare only | $371.54 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $2,691.53 Typical High $2,818.38 | Professional | 62 · Two surgeons | $2,290.87 | $2,691.53 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,466.84 Median $5,128.61 Typical High $5,370.32 | Professional | 63 · Small infant | $4,466.84 | $5,128.61 | $5,370.32 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $676.08 Typical High $724.44 | Professional | 80 · Assistant surgeon | $588.84 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $588.84 Median $676.08 Typical High $724.44 | Professional | 81 · Minimal assistant surgeon | $588.84 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $588.84 Median $676.08 Typical High $724.44 | Professional | 82 · Assistant surgeon, no resident | $588.84 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $575.44 Typical High $616.60 | Professional | AS · PA/NP assist | $501.19 | $575.44 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $1,548.82 | $3,311.31 | $3,311.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $616.60 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $2,344.23 | $4,897.79 | $4,897.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $467.74 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $309.03 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,187.76 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | 22 · Increased work | $4,786.30 | $4,786.30 | $4,786.30 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $436.52 | $436.52 | $436.52 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 62 · Two surgeons | $2,754.23 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | 63 · Small infant | $4,786.30 | $4,786.30 | $4,786.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,235.94 | $3,235.94 |
Where Idaho sits
The same service costs 22.4 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
$3,981
AK $7,943TX $355
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.