How much rates vary
Facilitymedian $380 · 10th to 90th $129 to $2,138Professionalmedian $195 · 10th to 90th $145 to $275
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $218.78 | Professional | None | $117.49 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $154.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $302.00 | Professional | None | $165.96 | $213.80 | $302.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $144.54 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $128.82 | $144.54 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $128.82 Typical High $173.78 | Facility | None | $114.82 | $128.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $223.87 | Professional | None | $128.82 | $162.18 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $4,466.84 | Facility | None | $131.83 | $218.78 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $275.42 | Professional | None | $158.49 | $204.17 | $275.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $154.88 |
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 $154.88 Median $162.18 Typical High $234.42 | Facility | None | $154.88 | $162.18 | $234.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $275.42 | Professional | None | $162.18 | $190.55 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $181.97 |
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 $165.96 Median $204.17 Typical High $275.42 | Professional | None | $165.96 | $204.17 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $891.25 | Facility | None | $131.83 | $134.90 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
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 $112.20 Median $154.88 Typical High $229.09 | Professional | None | $112.20 | $154.88 | $229.09 |
15 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 $79.43 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $79.43 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $31.62 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $120.23 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $21.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $186.21 Typical High $281.84 | Professional | 54 · Surgery only | $158.49 | $186.21 | $281.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $20.42 | $25.12 | $30.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $245.47 Typical High $363.08 | Professional | 63 · Small infant | $213.80 | $245.47 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $79.43 | $79.43 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $31.62 | $31.62 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $120.23 | $120.23 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $24.55 |
Where Idaho sits
The same service costs 4.1 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
$200
AK $437KY $107
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.