How much rates vary
Facilitymedian $589 · 10th to 90th $229 to $4,786Professionalmedian $363 · 10th to 90th $263 to $550
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 $302.00 Median $331.13 Typical High $512.86 | Professional | None | $302.00 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $354.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $245.47 Median $1,258.93 Typical High $4,897.79 | Facility | None | $245.47 | $1,258.93 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $616.60 | Professional | None | $288.40 | $389.05 | $616.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $316.23 | Facility | None | $204.17 | $229.09 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $467.74 | Professional | None | $239.88 | $331.13 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $467.74 Typical High $5,495.41 | Facility | None | $213.80 | $467.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | None | $288.40 | $363.08 | $549.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $354.81 |
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 $281.84 Median $295.12 Typical High $489.78 | Facility | None | $281.84 | $295.12 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $575.44 | Professional | None | $295.12 | $346.74 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $371.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | None | $288.40 | $363.08 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $3,890.45 | Facility | None | $275.42 | $281.84 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $467.74 | Professional | None | $204.17 | $309.03 | $467.74 |
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 $165.96 Median $165.96 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 53 · Discontinued | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $380.19 | Professional | 54 · Surgery only | $245.47 | $245.47 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $51.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $288.40 | $467.74 | $562.34 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $64.57 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $64.57 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $588.84 Typical High $707.95 | Professional | 63 · Small infant | $446.68 | $588.84 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $165.96 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 53 · Discontinued | $66.07 | $66.07 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $380.19 | Professional | 54 · Surgery only | $245.47 | $245.47 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $51.29 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $223.87 | $346.74 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $48.98 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 11th of 51
$372
AK $759TX $214
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.