How much rates vary
Facilitymedian $288 · 10th to 90th $126 to $1,660Professionalmedian $126 · 10th to 90th $78 to $295
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 $794.33 Median $4,466.84 Typical High $7,079.46 | Facility | None | $794.33 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $239.88 | Professional | None | $72.44 | $134.90 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $112.20 Typical High $177.83 | Professional | 54 · Surgery only | $66.07 | $112.20 | $177.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $269.15 Typical High $1,659.59 | Facility | None | $125.89 | $269.15 | $1,659.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $85.11 Median $223.87 Typical High $316.23 | Professional | None | $85.11 | $223.87 | $316.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $89.13 Typical High $251.19 | Professional | 54 · Surgery only | $77.62 | $89.13 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $190.55 | Facility | None | $125.89 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $245.47 | Professional | None | $81.28 | $109.65 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $239.88 Typical High $5,495.41 | Facility | None | $72.44 | $239.88 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $295.12 | Professional | None | $75.86 | $144.54 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $177.83 | Professional | 54 · Surgery only | $66.07 | $66.07 | $177.83 |
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 $74.13 Median $77.62 Typical High $251.19 | Facility | None | $74.13 | $77.62 | $251.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $173.78 Typical High $295.12 | Professional | None | $77.62 | $173.78 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $181.97 | Professional | 54 · Surgery only | $67.61 | $67.61 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $295.12 | Professional | None | $85.11 | $120.23 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $251.19 | Professional | None | $64.57 | $125.89 | $251.19 |
13 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 $43.65 Median $75.86 Typical High $120.23 | Professional | 52 · Reduced service | $43.65 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $30.20 Typical High $47.86 | Professional | 53 · Discontinued | $17.38 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.39 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $15.14 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.71 | $15.14 | $23.99 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.55 Typical High $33.11 | Professional | 55 · Aftercare only | $8.51 | $9.55 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $104.71 Median $120.23 Typical High $323.59 | Professional | 63 · Small infant | $104.71 | $120.23 | $323.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $69.18 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $60.26 | $69.18 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $120.23 | Professional | 52 · Reduced service | $43.65 | $43.65 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $47.86 | Professional | 53 · Discontinued | $17.38 | $17.38 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $23.99 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $26.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $194.98 |
Where Idaho sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 18th of 51
$162
AK $282MT $107
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.