How much rates vary
Facilitymedian $1,479 · 10th to 90th $692 to $4,786Professionalmedian $1,122 · 10th to 90th $832 to $1,479
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 $1,202.26 Median $1,380.38 Typical High $5,495.41 | Facility | None | $1,202.26 | $1,380.38 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,174.90 | Professional | None | $676.08 | $1,000.00 | $1,174.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $4,786.30 | Facility | None | $1,258.93 | $1,949.84 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,174.90 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,202.26 | Professional | None | $831.76 | $1,047.13 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $7,762.47 | Facility | None | $794.33 | $1,202.26 | $7,762.47 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,479.11 | Professional | None | $891.25 | $1,174.90 | $1,479.11 |
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 $954.99 Median $1,288.25 Typical High $1,949.84 | Facility | None | $954.99 | $1,288.25 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,513.56 | Professional | None | $954.99 | $1,122.02 | $1,513.56 |
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 $1,023.29 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,174.90 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,754.23 | Facility | None | $724.44 | $724.44 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | None | $724.44 | $724.44 | $977.24 |
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 $724.44 Median $954.99 Typical High $1,318.26 | Professional | None | $724.44 | $954.99 | $1,318.26 |
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 $501.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $912.01 | $1,288.25 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $131.83 Typical High $169.82 | Professional | 55 · Aftercare only | $102.33 | $131.83 | $169.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | 63 · Small infant | $1,230.27 | $1,479.11 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $199.53 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $794.33 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $977.24 |
Where Idaho sits
The same service costs 4.6 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
$1,148
AK $2,692TX $589
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.