How much rates vary
Facilitymedian $550 · 10th to 90th $324 to $2,138Professionalmedian $389 · 10th to 90th $288 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 $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 $257.04 Median $323.59 Typical High $467.74 | Professional | None | $257.04 | $323.59 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $870.96 Typical High $2,137.96 | Facility | None | $524.81 | $870.96 | $2,137.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $660.69 | Professional | None | $323.59 | $407.38 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $478.63 Typical High $645.65 | Facility | None | $426.58 | $478.63 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $489.78 | Professional | None | $263.03 | $346.74 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $467.74 Typical High $4,466.84 | Facility | None | $257.04 | $467.74 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $602.56 | Professional | None | $302.00 | $407.38 | $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 $288.40 Median $302.00 Typical High $512.86 | Facility | None | $288.40 | $302.00 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $602.56 | Professional | None | $302.00 | $363.08 | $602.56 |
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 $323.59 Median $407.38 Typical High $602.56 | Professional | None | $323.59 | $407.38 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $1,412.54 | Facility | None | $288.40 | $295.12 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
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 $234.42 Median $338.84 Typical High $512.86 | Professional | None | $234.42 | $338.84 | $512.86 |
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 $162.18 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $162.18 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | 54 · Surgery only | $239.88 | $239.88 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $331.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $478.63 Typical High $588.84 | Professional | 54 · Surgery only | $302.00 | $478.63 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $45.71 Typical High $67.61 | Professional | 55 · Aftercare only | $32.36 | $45.71 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $407.38 Median $478.63 Typical High $794.33 | Professional | 63 · Small infant | $407.38 | $478.63 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $275.42 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $229.09 | $275.42 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $162.18 | $162.18 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $64.57 | $95.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | 54 · Surgery only | $239.88 | $239.88 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $46.77 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $251.19 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $398.11 |
Where Idaho sits
The same service costs 3.6 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
$417
AK $851KY $234
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.