How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,995 to $15,849Professionalmedian $2,884 · 10th to 90th $1,820 to $3,715
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 $1,995.26 Median $3,715.35 Typical High $3,715.35 | Professional | None | $1,995.26 | $3,715.35 | $3,715.35 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $17,378.01 | Facility | None | $2,630.27 | $4,365.16 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,162.28 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $2,398.83 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,290.87 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $3,715.35 Typical High $5,495.41 | Facility | None | $1,380.38 | $3,715.35 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $3,715.35 | Professional | None | $1,995.26 | $3,162.28 | $3,715.35 |
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 $2,344.23 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,344.23 | $2,884.03 | $2,884.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,884.03 | $2,884.03 | $5,011.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,964.78 Median $15,848.93 Typical High $21,877.62 | Facility | None | $10,964.78 | $15,848.93 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $3,715.35 | Professional | None | $2,754.23 | $3,311.31 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $9,332.54 | Facility | None | $1,380.38 | $1,412.54 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,380.38 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,344.23 | $3,467.37 |
17 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 $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,000.00 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $398.11 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,479.11 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $295.12 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $199.53 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,380.38 | $2,630.27 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,691.53 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,344.23 | $2,691.53 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $295.12 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $295.12 | $323.59 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,862.09 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,621.81 | $1,862.09 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,090.30 Median $3,548.13 Typical High $3,890.45 | Professional | 63 · Small infant | $3,090.30 | $3,548.13 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,089.30 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,089.30 | $2,290.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,000.00 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $398.11 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,479.11 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $295.12 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $199.53 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,380.38 | $2,630.27 | $2,630.27 |
Where Idaho sits
The same service costs 6.6 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 $6,607TX $1,000
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.