How much rates vary
Facilitymedian $1,000 · 10th to 90th $295 to $4,169Professionalmedian $302 · 10th to 90th $219 to $427
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 $295.12 Median $407.38 Typical High $5,495.41 | Facility | None | $295.12 | $407.38 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $338.84 | Professional | None | $181.97 | $245.47 | $338.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,862.09 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $489.78 | Professional | None | $257.04 | $338.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $354.81 | Professional | None | $199.53 | $251.19 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $4,466.84 | Facility | None | $208.93 | $338.84 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $426.58 | Professional | None | $239.88 | $316.23 | $426.58 |
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 $239.88 Median $251.19 Typical High $380.19 | Facility | None | $239.88 | $251.19 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $446.68 | Professional | None | $251.19 | $295.12 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $426.58 | Professional | None | $257.04 | $316.23 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $3,311.31 | Facility | None | $213.80 | $218.78 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | None | $213.80 | $213.80 | $281.84 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $363.08 | Professional | None | $173.78 | $239.88 | $363.08 |
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 $123.03 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $123.03 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $186.21 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $239.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $363.08 | Professional | 54 · Surgery only | $245.47 | $275.42 | $363.08 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $371.54 Typical High $575.44 | Professional | 63 · Small infant | $323.59 | $371.54 | $575.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $123.03 | $123.03 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $48.98 | $48.98 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $186.21 | $186.21 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $194.98 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $38.02 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $281.84 |
Where Idaho sits
The same service costs 4.6 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· 11th of 51
$316
AK $794KY $174
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.