How much rates vary
Facilitymedian $407 · 10th to 90th $145 to $1,820Professionalmedian $214 · 10th to 90th $155 to $331
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 $173.78 Median $389.05 Typical High $7,079.46 | Facility | None | $173.78 | $389.05 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $263.03 | Professional | None | $141.25 | $181.97 | $263.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $158.49 Median $645.65 Typical High $1,819.70 | Facility | None | $158.49 | $645.65 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $363.08 | Professional | None | $177.83 | $223.87 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $199.53 | Facility | None | $128.82 | $144.54 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $269.15 | Professional | None | $151.36 | $190.55 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $263.03 Typical High $4,466.84 | Facility | None | $154.88 | $263.03 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $331.13 | Professional | None | $162.18 | $223.87 | $331.13 |
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 $281.84 | Facility | None | $162.18 | $169.82 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $331.13 | Professional | None | $169.82 | $199.53 | $331.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,737.80 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $331.13 | Professional | None | $177.83 | $223.87 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $1,000.00 | Facility | None | $158.49 | $162.18 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
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 $123.03 Median $181.97 Typical High $281.84 | Professional | None | $123.03 | $181.97 | $281.84 |
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 $87.10 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $181.97 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $338.84 | Professional | 54 · Surgery only | $158.49 | $194.98 | $338.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $31.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $229.09 Median $263.03 Typical High $380.19 | Professional | 63 · Small infant | $229.09 | $263.03 | $380.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $158.49 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $128.82 | $158.49 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $87.10 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $34.67 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $131.83 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $26.30 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $181.97 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $138.04 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $218.78 |
Where Idaho sits
The same service costs 3.8 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
$224
AK $525KY $138
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.