How much rates vary
Facilitymedian $1,380 · 10th to 90th $676 to $4,786Professionalmedian $1,096 · 10th to 90th $851 to $1,514
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 $676.08 Median $1,000.00 Typical High $1,202.26 | Professional | None | $676.08 | $1,000.00 | $1,202.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $4,786.30 | Facility | None | $1,380.38 | $2,137.96 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,202.26 | $1,698.24 |
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 $812.83 Median $1,023.29 Typical High $1,258.93 | Professional | None | $812.83 | $1,023.29 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,047.13 Typical High $4,466.84 | Facility | None | $691.83 | $1,047.13 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,513.56 | Professional | None | $933.25 | $1,202.26 | $1,513.56 |
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 $891.25 Median $954.99 Typical High $1,318.26 | Facility | None | $891.25 | $954.99 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,548.82 | Professional | None | $954.99 | $1,096.48 | $1,548.82 |
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 $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,202.26 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $3,890.45 | Facility | None | $741.31 | $758.58 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
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 $977.24 Typical High $1,380.38 | Professional | None | $724.44 | $977.24 | $1,380.38 |
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 $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $831.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,445.44 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $144.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,584.89 Typical High $2,041.74 | Professional | 63 · Small infant | $1,202.26 | $1,584.89 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $707.95 | $933.25 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,000.00 |
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· 10th of 51
$1,175
AK $2,630TX $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.