How much rates vary
Facilitymedian $407 · 10th to 90th $158 to $1,820Professionalmedian $263 · 10th to 90th $195 to $372
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 $263.03 Median $346.74 Typical High $5,495.41 | Facility | None | $263.03 | $346.74 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $295.12 | Professional | None | $158.49 | $218.78 | $295.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $691.83 Typical High $1,819.70 | Facility | None | $173.78 | $691.83 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $407.38 | Professional | None | $229.09 | $288.40 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $218.78 | Facility | None | $141.25 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $302.00 | Professional | None | $177.83 | $223.87 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $1,778.28 | Facility | None | $190.55 | $295.12 | $1,778.28 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $371.54 | Professional | None | $218.78 | $281.84 | $371.54 |
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 $208.93 Median $218.78 Typical High $323.59 | Facility | None | $208.93 | $218.78 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $380.19 | Professional | None | $218.78 | $257.04 | $380.19 |
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 $371.54 | Professional | None | $229.09 | $281.84 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $1,412.54 | Facility | None | $177.83 | $181.97 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
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 $316.23 | Professional | None | $158.49 | $218.78 | $316.23 |
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 $109.65 Median $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $109.65 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $251.19 Typical High $346.74 | Professional | 54 · Surgery only | $218.78 | $251.19 | $346.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $28.18 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 63 · Small infant | $288.40 | $354.81 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $158.49 | $245.47 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $109.65 | $109.65 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $44.67 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $165.96 | $165.96 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $229.09 | Professional | 54 · Surgery only | $173.78 | $173.78 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $245.47 |
Where Idaho sits
The same service costs 3.9 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
$269
AK $603KY $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.