How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,698 to $13,490Professionalmedian $741 · 10th to 90th $646 to $1,318
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $15,848.93 | Facility | None | $5,495.41 | $6,165.95 | $15,848.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,174.90 | Professional | None | $630.96 | $741.31 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $5,011.87 Typical High $6,760.83 | Facility | None | $4,466.84 | $5,011.87 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $794.33 Typical High $5,495.41 | Facility | None | $691.83 | $794.33 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | None | $691.83 | $691.83 | $870.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $11,220.18 Typical High $16,982.44 | Facility | None | $7,585.78 | $11,220.18 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Facility | None | $741.31 | $741.31 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $5,495.41 | Professional | None | $741.31 | $741.31 | $5,495.41 |
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 $741.31 Median $1,000.00 Typical High $1,445.44 | Professional | None | $741.31 | $1,000.00 | $1,445.44 |
11 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 $346.74 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $79.43 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $346.74 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $524.81 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $79.43 |
Where Idaho sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 27th of 51
$1,175
TX $3,981DE $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.