How much rates vary
Facilitymedian $263 · 10th to 90th $138 to $1,047Professionalmedian $200 · 10th to 90th $145 to $288
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 $186.21 Median $269.15 Typical High $5,495.41 | Facility | None | $186.21 | $269.15 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $234.42 | Professional | None | $120.23 | $165.96 | $234.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $331.13 Typical High $1,047.13 | Facility | None | $144.54 | $331.13 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $331.13 | Professional | None | $162.18 | $234.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $138.04 Typical High $190.55 | Facility | None | $123.03 | $138.04 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $239.88 | Professional | None | $134.90 | $169.82 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $295.12 Typical High $4,677.35 | Facility | None | $134.90 | $295.12 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $288.40 | Professional | None | $147.91 | $199.53 | $288.40 |
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 $162.18 Median $169.82 Typical High $263.03 | Facility | None | $162.18 | $169.82 | $263.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $309.03 | Professional | None | $169.82 | $199.53 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $288.40 | Professional | None | $162.18 | $199.53 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $549.54 | Facility | None | $144.54 | $147.91 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | None | $144.54 | $144.54 | $190.55 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $251.19 | Professional | None | $107.15 | $162.18 | $251.19 |
19 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 $79.43 Median $79.43 Typical High $114.82 | Professional | 52 · Reduced service | $79.43 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $169.82 | Professional | 54 · Surgery only | $117.49 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $109.65 | $109.65 | $158.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $208.93 Typical High $309.03 | Professional | 54 · Surgery only | $162.18 | $208.93 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $22.39 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $269.15 Typical High $398.11 | Professional | 63 · Small infant | $218.78 | $269.15 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $79.43 | $104.71 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $31.62 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $117.49 | $154.88 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $22.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $109.65 | $109.65 | $158.49 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | 54 · Surgery only | $125.89 | $125.89 | $181.97 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $25.70 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $25.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $194.98 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$200
AK $447KY $110
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.