How much rates vary
Facilitymedian $575 · 10th to 90th $162 to $4,266Professionalmedian $282 · 10th to 90th $209 to $389
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 $245.47 Median $1,412.54 Typical High $7,079.46 | Facility | None | $245.47 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $316.23 | Professional | None | $177.83 | $234.42 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $1,819.70 Typical High $4,265.80 | Facility | None | $173.78 | $1,819.70 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $436.52 | Professional | None | $239.88 | $316.23 | $436.52 |
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 $194.98 Median $245.47 Typical High $323.59 | Professional | None | $194.98 | $245.47 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $4,466.84 | Facility | None | $194.98 | $316.23 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $389.05 | Professional | None | $218.78 | $302.00 | $389.05 |
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 $229.09 Median $239.88 Typical High $346.74 | Facility | None | $229.09 | $239.88 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $407.38 | Professional | None | $239.88 | $281.84 | $407.38 |
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 $239.88 Median $302.00 Typical High $389.05 | Professional | None | $239.88 | $302.00 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $3,311.31 | Facility | None | $194.98 | $199.53 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
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 $169.82 Median $234.42 Typical High $338.84 | Professional | None | $169.82 | $234.42 | $338.84 |
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 $117.49 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $46.77 | $63.10 |
Aetna 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 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $218.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $316.23 | $380.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $38.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | 63 · Small infant | $288.40 | $363.08 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $117.49 | $117.49 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $46.77 | $63.10 |
Moda Health 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 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $218.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $186.21 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $263.03 |
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
$282
AK $646KY $162
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.