How much rates vary
Facilitymedian $1,995 · 10th to 90th $550 to $9,120Professionalmedian $4,266 · 10th to 90th $2,884 to $5,495
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 $2,951.21 Median $5,495.41 Typical High $5,495.41 | Professional | None | $2,951.21 | $5,495.41 | $5,495.41 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,128.31 Median $8,912.51 Typical High $10,715.19 | Facility | None | $8,128.31 | $8,912.51 | $10,715.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $4,897.79 | Professional | None | $3,890.45 | $4,570.88 | $4,897.79 |
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 $2,818.38 Median $3,162.28 Typical High $3,630.78 | Professional | None | $2,818.38 | $3,162.28 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $7,943.28 | Facility | None | $1,995.26 | $5,495.41 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,951.21 Median $5,495.41 Typical High $5,495.41 | Professional | None | $2,951.21 | $5,495.41 | $5,495.41 |
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 $3,467.37 Median $4,265.80 Typical High $4,265.80 | Facility | None | $3,467.37 | $4,265.80 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,623.41 | Professional | None | $4,265.80 | $4,265.80 | $5,623.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,365.16 Median $4,897.79 Typical High $5,495.41 | Professional | None | $4,365.16 | $4,897.79 | $5,495.41 |
Select Health Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,238.72 | Facility | None | $1,995.26 | $1,995.26 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,290.87 | $3,548.13 |
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 $2,570.40 Median $3,467.37 Typical High $4,897.79 | Professional | None | $2,570.40 | $3,467.37 | $4,897.79 |
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 $1,479.11 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,479.11 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $588.84 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,187.76 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $436.52 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $295.12 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,041.74 | $3,890.45 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,890.45 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,548.13 | $3,890.45 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 55 · Aftercare only | $389.05 | $436.52 | $478.63 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,454.71 Median $2,754.23 Typical High $2,951.21 | Professional | 62 · Two surgeons | $2,454.71 | $2,754.23 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,677.35 Median $5,248.07 Typical High $5,623.41 | Professional | 63 · Small infant | $4,677.35 | $5,248.07 | $5,623.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,019.95 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,019.95 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 80 · Assistant surgeon | $630.96 | $691.83 | $758.58 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $630.96 | $691.83 | $758.58 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $630.96 | $691.83 | $758.58 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $588.84 Typical High $645.65 | Professional | AS · PA/NP assist | $537.03 | $588.84 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,479.11 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $588.84 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,187.76 | $4,168.69 | $4,168.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $436.52 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $295.12 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,041.74 | $3,890.45 | $3,890.45 |
Where Idaho sits
The same service costs 24.0 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
$4,266
AK $9,772TX $407
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.