How much rates vary
Facilitymedian $1,380 · 10th to 90th $676 to $4,786Professionalmedian $1,380 · 10th to 90th $1,072 to $1,905
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,513.56 | Professional | None | $851.14 | $1,230.27 | $1,513.56 |
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 $1,258.93 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,513.56 | $2,137.96 |
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 $1,023.29 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,288.25 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,318.26 Typical High $5,495.41 | Facility | None | $891.25 | $1,318.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,513.56 | $1,905.46 |
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 $1,122.02 Median $1,174.90 Typical High $1,659.59 | Facility | None | $1,122.02 | $1,174.90 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,380.38 | $1,949.84 |
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 $1,258.93 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,548.82 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $3,890.45 | Facility | None | $933.25 | $954.99 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
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 $891.25 Median $1,230.27 Typical High $1,737.80 | Professional | None | $891.25 | $1,230.27 | $1,737.80 |
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 $616.60 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $186.21 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,778.28 Typical High $2,511.89 | Professional | 63 · Small infant | $1,548.82 | $1,778.28 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $616.60 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $245.47 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,288.25 |
Where Idaho sits
The same service costs 4.5 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
$1,380
AK $3,311TX $741
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.