How much rates vary
Facilitymedian $1,445 · 10th to 90th $550 to $6,457Professionalmedian $3,020 · 10th to 90th $1,862 to $3,890
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 $1,737.80 Median $3,890.45 Typical High $3,890.45 | Professional | None | $1,737.80 | $3,890.45 | $3,890.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $6,309.57 Typical High $7,585.78 | Facility | None | $5,888.44 | $6,309.57 | $7,585.78 |
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 |
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 $1,995.26 Median $2,398.83 Typical High $2,691.53 | Professional | None | $1,995.26 | $2,398.83 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,890.45 Typical High $5,623.41 | Facility | None | $1,445.44 | $3,890.45 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,089.30 | $3,311.31 | $3,890.45 |
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 $2,511.89 Median $3,019.95 Typical High $3,019.95 | Facility | None | $2,511.89 | $3,019.95 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,890.45 | Professional | None | $3,019.95 | $3,019.95 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $3,890.45 | Professional | None | $2,818.38 | $3,467.37 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,445.44 | $1,621.81 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,445.44 | $2,041.74 |
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 $1,659.59 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,454.71 | $3,630.78 |
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 $1,000.00 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,000.00 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $398.11 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,513.56 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $302.00 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $199.53 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,754.23 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,818.38 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,454.71 | $2,818.38 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $316.23 | $338.84 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $1,949.84 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,698.24 | $1,949.84 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,801.89 Typical High $4,073.80 | Professional | 63 · Small infant | $3,311.31 | $3,801.89 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,187.76 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,187.76 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $501.19 Typical High $549.54 | Professional | 80 · Assistant surgeon | $436.52 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $436.52 Median $501.19 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $436.52 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $501.19 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $426.58 Typical High $467.74 | Professional | AS · PA/NP assist | $371.54 | $426.58 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,047.13 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $416.87 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,548.82 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $309.03 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $208.93 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,754.23 | $2,754.23 |
Where Idaho sits
The same service costs 5.9 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· 12th of 51
$2,884
AK $6,918TX $1,175
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.