How much rates vary
Facilitymedian $417 · 10th to 90th $162 to $1,862Professionalmedian $269 · 10th to 90th $195 to $380
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 $223.87 Median $316.23 Typical High $7,079.46 | Facility | None | $223.87 | $316.23 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $302.00 | Professional | None | $165.96 | $223.87 | $302.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $741.31 Typical High $1,819.70 | Facility | None | $173.78 | $741.31 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $416.87 | Professional | None | $229.09 | $295.12 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $223.87 | Facility | None | $144.54 | $162.18 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $309.03 | Professional | None | $181.97 | $229.09 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $4,466.84 | Facility | None | $186.21 | $302.00 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $380.19 | Professional | None | $208.93 | $281.84 | $380.19 |
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 $213.80 Median $223.87 Typical High $331.13 | Facility | None | $213.80 | $223.87 | $331.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $389.05 | Professional | None | $223.87 | $263.03 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,819.70 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $380.19 | Professional | None | $229.09 | $281.84 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $1,412.54 | Facility | None | $186.21 | $190.55 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | None | $186.21 | $186.21 | $251.19 |
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 $158.49 Median $218.78 Typical High $323.59 | Professional | None | $158.49 | $218.78 | $323.59 |
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 $112.20 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $112.20 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | 53 · Discontinued | $44.67 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 54 · Surgery only | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $208.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $213.80 | $269.15 | $338.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $39.81 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $39.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $295.12 Median $346.74 Typical High $446.68 | Professional | 63 · Small infant | $295.12 | $346.74 | $446.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $112.20 | $112.20 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | 53 · Discontinued | $44.67 | $44.67 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 54 · Surgery only | $169.82 | $169.82 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $30.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $208.93 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $177.83 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $33.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $251.19 |
Where Idaho sits
The same service costs 4.0 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· 9th of 51
$275
AK $617KY $155
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.