How much rates vary
Facilitymedian $724 · 10th to 90th $437 to $2,239Professionalmedian $661 · 10th to 90th $501 to $851
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 $446.68 Median $588.84 Typical High $645.65 | Professional | None | $446.68 | $588.84 | $645.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,238.72 | Facility | None | $1,737.80 | $1,862.09 | $2,238.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $912.01 | Professional | None | $549.54 | $758.58 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $794.33 | Professional | None | $588.84 | $676.08 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $5,495.41 | Facility | None | $371.54 | $645.65 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $812.83 | Professional | None | $501.19 | $645.65 | $812.83 |
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 $645.65 Median $724.44 Typical High $724.44 | Facility | None | $645.65 | $724.44 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | None | $707.95 | $724.44 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $912.01 | Professional | None | $549.54 | $549.54 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $416.87 | Facility | None | $371.54 | $371.54 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $588.84 | Professional | None | $371.54 | $371.54 | $588.84 |
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 $489.78 Median $691.83 Typical High $977.24 | Professional | None | $489.78 | $691.83 | $977.24 |
19 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 $251.19 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $64.57 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $630.96 | $707.95 | $831.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $91.20 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $489.78 Typical High $575.44 | Professional | 62 · Two surgeons | $436.52 | $489.78 | $575.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $933.25 Typical High $1,096.48 | Professional | 63 · Small infant | $851.14 | $933.25 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $645.65 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 80 · Assistant surgeon | $112.20 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $112.20 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $104.71 Typical High $125.89 | Professional | AS · PA/NP assist | $95.50 | $104.71 | $125.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $64.57 |
Where Idaho sits
The same service costs 3.4 times more in Alaska 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· 20th of 51
$676
AK $1,514UT $447
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.