How much rates vary
Facilitymedian $380 · 10th to 90th $191 to $2,138Professionalmedian $282 · 10th to 90th $204 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 $173.78 Median $223.87 Typical High $346.74 | Professional | None | $173.78 | $223.87 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $204.17 Median $549.54 Typical High $2,137.96 | Facility | None | $204.17 | $549.54 | $2,137.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $478.63 | Professional | None | $229.09 | $302.00 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $257.04 | Facility | None | $169.82 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $363.08 | Professional | None | $204.17 | $257.04 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $323.59 Typical High $5,495.41 | Facility | None | $134.90 | $323.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $436.52 | Professional | None | $213.80 | $288.40 | $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 $204.17 Median $218.78 Typical High $380.19 | Facility | None | $204.17 | $218.78 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $446.68 | Professional | None | $218.78 | $263.03 | $446.68 |
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 $288.40 Typical High $436.52 | Professional | None | $229.09 | $288.40 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $891.25 | Facility | None | $213.80 | $213.80 | $891.25 |
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 $162.18 Median $251.19 Typical High $380.19 | Professional | None | $162.18 | $251.19 | $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 $112.20 Median $112.20 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $112.20 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $45.71 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $169.82 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $245.47 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $416.87 | Professional | 54 · Surgery only | $204.17 | $245.47 | $416.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $50.12 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $50.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $323.59 Typical High $489.78 | Professional | 63 · Small infant | $275.42 | $323.59 | $489.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $112.20 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $45.71 | $45.71 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $169.82 | $169.82 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $177.83 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $38.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $295.12 |
Where Idaho sits
The same service costs 3.4 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· 13th of 51
$288
AK $603KY $178
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.