How much rates vary
Facilitymedian $407 · 10th to 90th $170 to $4,169Professionalmedian $234 · 10th to 90th $170 to $380
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 $234.42 Median $1,412.54 Typical High $7,079.46 | Facility | None | $234.42 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $302.00 | Professional | None | $173.78 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $134.90 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $134.90 | $213.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $186.21 Median $741.31 Typical High $4,265.80 | Facility | None | $186.21 | $741.31 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $416.87 | Professional | None | $190.55 | $257.04 | $416.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $169.82 Typical High $234.42 | Facility | None | $151.36 | $169.82 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | None | $162.18 | $213.80 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $4,466.84 | Facility | None | $158.49 | $275.42 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $380.19 | Professional | None | $181.97 | $275.42 | $380.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $213.80 |
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 $173.78 Median $181.97 Typical High $331.13 | Facility | None | $173.78 | $181.97 | $331.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $389.05 | Professional | None | $181.97 | $229.09 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $251.19 |
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 $190.55 Median $245.47 Typical High $380.19 | Professional | None | $190.55 | $245.47 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $1,584.89 | Facility | None | $181.97 | $186.21 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Professional | None | $181.97 | $181.97 | $251.19 |
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 $131.83 Median $204.17 Typical High $323.59 | Professional | None | $131.83 | $204.17 | $323.59 |
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 $93.33 Median $95.50 Typical High $151.36 | Professional | 52 · Reduced service | $93.33 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $60.26 | Professional | 53 · Discontinued | $37.15 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $30.20 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $208.93 Typical High $389.05 | Professional | 54 · Surgery only | $169.82 | $208.93 | $389.05 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $43.65 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $229.09 Median $426.58 Typical High $524.81 | Professional | 63 · Small infant | $229.09 | $426.58 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $151.36 | Professional | 52 · Reduced service | $93.33 | $93.33 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 53 · Discontinued | $37.15 | $37.15 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $141.25 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $30.20 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $147.91 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $33.88 |
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· 15th of 51
$240
AK $501KY $138
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.