How much rates vary
Facilitymedian $1,047 · 10th to 90th $550 to $4,786Professionalmedian $2,188 · 10th to 90th $1,585 to $3,020
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 $1,621.81 Median $3,019.95 Typical High $3,019.95 | Professional | None | $1,621.81 | $3,019.95 | $3,019.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $5,370.32 | Facility | None | $4,168.69 | $4,466.84 | $5,370.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,344.23 | $2,511.89 |
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 $1,445.44 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,737.80 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $3,019.95 Typical High $4,466.84 | Facility | None | $1,047.13 | $3,019.95 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,951.21 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,951.21 | $3,019.95 |
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 $1,778.28 Median $2,187.76 Typical High $2,187.76 | Facility | None | $1,778.28 | $2,187.76 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,511.89 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Facility | None | $1,047.13 | $1,047.13 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,230.27 | $1,905.46 |
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 $1,258.93 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,778.28 | $2,454.71 |
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 $812.83 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $812.83 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $323.59 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,202.26 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $239.88 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $162.18 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,089.30 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,089.30 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,819.70 | $2,089.30 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,398.83 Median $2,754.23 Typical High $2,951.21 | Professional | 63 · Small infant | $2,398.83 | $2,754.23 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,621.81 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,621.81 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $371.54 Typical High $389.05 | Professional | 80 · Assistant surgeon | $323.59 | $371.54 | $389.05 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $371.54 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $323.59 | $371.54 | $389.05 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $371.54 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $371.54 | $389.05 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $316.23 Typical High $331.13 | Professional | AS · PA/NP assist | $275.42 | $316.23 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $812.83 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $323.59 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,202.26 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $239.88 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $162.18 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,089.30 | $2,089.30 |
Where Idaho sits
The same service costs 6.5 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· 10th of 51
$2,188
AK $5,012TX $776
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.