How much rates vary
Facilitymedian $417 · 10th to 90th $178 to $4,169Professionalmedian $316 · 10th to 90th $240 to $437
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $346.74 | Professional | None | $186.21 | $269.15 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $190.55 Median $870.96 Typical High $4,265.80 | Facility | None | $190.55 | $870.96 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $489.78 | Professional | None | $275.42 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $177.83 Typical High $239.88 | Facility | None | $158.49 | $177.83 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $363.08 | Professional | None | $218.78 | $275.42 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $346.74 Typical High $5,495.41 | Facility | None | $186.21 | $346.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $436.52 | Professional | None | $263.03 | $346.74 | $436.52 |
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 $251.19 Median $269.15 Typical High $380.19 | Facility | None | $251.19 | $269.15 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $446.68 | Professional | None | $269.15 | $309.03 | $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 $275.42 Median $346.74 Typical High $436.52 | Professional | None | $275.42 | $346.74 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $1,621.81 | Facility | None | $213.80 | $218.78 | $1,621.81 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | None | $213.80 | $213.80 | $288.40 |
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 $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
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 $134.90 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $52.48 |
Aetna 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 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $245.47 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $446.68 | Professional | 54 · Surgery only | $257.04 | $302.00 | $446.68 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $45.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $338.84 Median $389.05 Typical High $602.56 | Professional | 63 · Small infant | $338.84 | $389.05 | $602.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $134.90 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $204.17 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $52.48 |
Moda Health 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 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $269.15 | Professional | 54 · Surgery only | $213.80 | $213.80 | $269.15 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $38.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $288.40 |
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
$316
AK $724KY $186
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.