How much rates vary
Facilitymedian $1,862 · 10th to 90th $933 to $4,467Professionalmedian $1,318 · 10th to 90th $1,000 to $1,862
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,862.09 | $1,862.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $4,466.84 | Facility | None | $3,019.95 | $3,235.94 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,380.38 | $1,621.81 |
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 $1,047.13 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,202.26 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,862.09 Typical High $5,495.41 | Facility | None | $891.25 | $1,862.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,584.89 | $1,862.09 |
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 $1,174.90 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,445.44 | $1,698.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Facility | None | $691.83 | $691.83 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,071.52 | Professional | None | $691.83 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,778.28 | Professional | None | $831.76 | $1,202.26 | $1,778.28 |
21 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 $524.81 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $524.81 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $208.93 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $776.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $154.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $104.71 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $724.44 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,174.90 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $162.18 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,023.29 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | 63 · Small infant | $1,584.89 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,096.48 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,096.48 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $223.87 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $524.81 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $208.93 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $794.33 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $158.49 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $104.71 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $741.31 | $1,318.26 | $1,318.26 |
Where Idaho sits
The same service costs 6.2 times more in Oklahoma than in Utah. 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· 16th of 51
$1,445
OK $3,631UT $589
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.