How much rates vary
Facilitymedian $2,042 · 10th to 90th $550 to $10,233Professionalmedian $4,467 · 10th to 90th $2,818 to $6,166
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 $2,511.89 Median $3,801.89 Typical High $6,165.95 | Professional | None | $2,511.89 | $3,801.89 | $6,165.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $9,332.54 Median $10,000.00 Typical High $12,022.64 | Facility | None | $9,332.54 | $10,000.00 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $5,370.32 | Professional | None | $4,265.80 | $5,011.87 | $5,370.32 |
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 $3,162.28 Median $3,715.35 Typical High $4,265.80 | Professional | None | $3,162.28 | $3,715.35 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $8,709.64 | Facility | None | $2,041.74 | $5,495.41 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,128.61 Typical High $6,165.95 | Professional | None | $3,235.94 | $5,128.61 | $6,165.95 |
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 $3,715.35 Median $4,570.88 Typical High $4,570.88 | Facility | None | $3,715.35 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,754.40 | Professional | None | $4,570.88 | $4,570.88 | $5,754.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,570.88 Median $5,370.32 Typical High $6,025.60 | Professional | None | $4,570.88 | $5,370.32 | $6,025.60 |
Select Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,454.71 | Facility | None | $2,187.76 | $2,187.76 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,187.76 | $3,235.94 |
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 $2,454.71 Median $3,890.45 Typical High $5,754.40 | Professional | None | $2,454.71 | $3,890.45 | $5,754.40 |
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 $1,621.81 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,621.81 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $645.65 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $2,398.83 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $489.78 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $323.59 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $2,238.72 | $4,265.80 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $4,265.80 Typical High $4,677.35 | Professional | 54 · Surgery only | $3,715.35 | $4,265.80 | $4,677.35 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $478.63 Typical High $512.86 | Professional | 55 · Aftercare only | $416.87 | $478.63 | $512.86 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $3,019.95 Typical High $3,235.94 | Professional | 62 · Two surgeons | $2,570.40 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,011.87 Median $5,754.40 Typical High $6,165.95 | Professional | 63 · Small infant | $5,011.87 | $5,754.40 | $6,165.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,311.31 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,311.31 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $758.58 Typical High $831.76 | Professional | 80 · Assistant surgeon | $660.69 | $758.58 | $831.76 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $660.69 Median $758.58 Typical High $831.76 | Professional | 81 · Minimal assistant surgeon | $660.69 | $758.58 | $831.76 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $660.69 Median $758.58 Typical High $831.76 | Professional | 82 · Assistant surgeon, no resident | $660.69 | $758.58 | $831.76 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $645.65 Typical High $707.95 | Professional | AS · PA/NP assist | $562.34 | $645.65 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,621.81 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $645.65 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $2,398.83 | $4,570.88 | $4,570.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $489.78 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $323.59 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $2,238.72 | $4,265.80 | $4,265.80 |
Where Idaho sits
The same service costs 17.0 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· 11th of 51
$4,467
AK $10,965TX $646
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.