How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $4,266Professionalmedian $437 · 10th to 90th $331 to $603
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 $446.68 Median $575.44 Typical High $5,495.41 | Facility | None | $446.68 | $575.44 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $478.63 | Professional | None | $269.15 | $371.54 | $478.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $4,365.16 | Facility | None | $1,000.00 | $2,238.72 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $691.83 | Professional | None | $380.19 | $489.78 | $691.83 |
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 $302.00 Median $380.19 Typical High $501.19 | Professional | None | $302.00 | $380.19 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $562.34 Typical High $7,585.78 | Facility | None | $208.93 | $562.34 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $602.56 | Professional | None | $371.54 | $467.74 | $602.56 |
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 $354.81 Median $371.54 Typical High $549.54 | Facility | None | $354.81 | $371.54 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | None | $371.54 | $436.52 | $645.65 |
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 $380.19 Median $467.74 Typical High $602.56 | Professional | None | $380.19 | $467.74 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $3,311.31 | Facility | None | $309.03 | $316.23 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | None | $309.03 | $309.03 | $407.38 |
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 $263.03 Median $363.08 Typical High $524.81 | Professional | None | $263.03 | $363.08 | $524.81 |
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 $186.21 Median $186.21 Typical High $239.88 | Professional | 52 · Reduced service | $186.21 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $602.56 | Professional | 54 · Surgery only | $380.19 | $426.58 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $38.02 | $47.86 | $63.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $562.34 Typical High $707.95 | Professional | 63 · Small infant | $489.78 | $562.34 | $707.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | 52 · Reduced service | $186.21 | $186.21 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $74.13 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $281.84 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $47.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $295.12 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $407.38 |
Where Idaho sits
The same service costs 4.8 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· 9th of 51
$468
AK $1,202KY $251
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.