How much rates vary
Facilitymedian $309 · 10th to 90th $170 to $1,047Professionalmedian $275 · 10th to 90th $200 to $501
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 $218.78 Median $602.56 Typical High $7,079.46 | Facility | None | $218.78 | $602.56 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $407.38 | Professional | None | $186.21 | $251.19 | $407.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $1,047.13 | Facility | None | $102.33 | $257.04 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $549.54 | Professional | None | $223.87 | $389.05 | $549.54 |
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 $199.53 Median $263.03 Typical High $416.87 | Professional | None | $199.53 | $263.03 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $407.38 Typical High $1,778.28 | Facility | None | $186.21 | $407.38 | $1,778.28 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $512.86 | Professional | None | $213.80 | $275.42 | $512.86 |
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 $436.52 | Facility | None | $204.17 | $218.78 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $512.86 | Professional | None | $218.78 | $302.00 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $512.86 | Professional | None | $223.87 | $295.12 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $263.03 | Facility | None | $194.98 | $245.47 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | None | $245.47 | $245.47 | $331.13 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $407.38 | Professional | None | $162.18 | $257.04 | $407.38 |
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 $109.65 Median $125.89 Typical High $204.17 | Professional | 52 · Reduced service | $109.65 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $51.29 Typical High $81.28 | Professional | 53 · Discontinued | $43.65 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $302.00 | Professional | 54 · Surgery only | $165.96 | $190.55 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.02 Typical High $60.26 | Professional | 55 · Aftercare only | $33.11 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.70 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $281.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $478.63 | Professional | 54 · Surgery only | $208.93 | $257.04 | $478.63 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $57.54 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $57.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $316.23 Typical High $660.69 | Professional | 63 · Small infant | $281.84 | $316.23 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $190.55 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $162.18 | $190.55 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $204.17 | Professional | 52 · Reduced service | $109.65 | $109.65 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $81.28 | Professional | 53 · Discontinued | $43.65 | $43.65 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $181.97 Typical High $302.00 | Professional | 54 · Surgery only | $165.96 | $181.97 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $60.26 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $281.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $173.78 | $309.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $331.13 |
Where Idaho sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 16th of 51
$275
AK $631MD $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.