How much rates vary
Facilitymedian $219 · 10th to 90th $100 to $631Professionalmedian $129 · 10th to 90th $91 to $219
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 $120.23 Median $204.17 Typical High $5,495.41 | Facility | None | $120.23 | $204.17 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $190.55 | Professional | None | $87.10 | $114.82 | $190.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $257.04 Typical High $602.56 | Facility | None | $79.43 | $257.04 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $234.42 | Professional | None | $104.71 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $177.83 | Professional | None | $91.20 | $123.03 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $169.82 Typical High $5,495.41 | Facility | None | $91.20 | $169.82 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $218.78 | Professional | None | $93.33 | $128.82 | $218.78 |
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 $100.00 Median $104.71 Typical High $186.21 | Facility | None | $100.00 | $104.71 | $186.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $218.78 | Professional | None | $104.71 | $128.82 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $218.78 | Professional | None | $104.71 | $134.90 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $218.78 | Facility | None | $102.33 | $104.71 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | None | $102.33 | $102.33 | $144.54 |
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 $72.44 Median $120.23 Typical High $186.21 | Professional | None | $72.44 | $120.23 | $186.21 |
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 $50.12 Median $53.70 Typical High $85.11 | Professional | 52 · Reduced service | $50.12 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $34.67 | Professional | 53 · Discontinued | $19.95 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $81.28 Typical High $128.82 | Professional | 54 · Surgery only | $75.86 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $25.70 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.00 | $10.72 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $75.86 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $70.79 | $75.86 | $120.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $117.49 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $117.49 | $173.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.49 Typical High $22.91 | Professional | 55 · Aftercare only | $11.22 | $13.49 | $22.91 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $131.83 Median $141.25 Typical High $288.40 | Professional | 63 · Small infant | $131.83 | $141.25 | $288.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $93.33 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $79.43 | $93.33 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $85.11 | Professional | 52 · Reduced service | $50.12 | $50.12 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $34.67 | Professional | 53 · Discontinued | $19.95 | $19.95 | $34.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | 54 · Surgery only | $75.86 | $75.86 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $25.70 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $16.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | 54 · Surgery only | $81.28 | $81.28 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $144.54 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 14th of 51
$135
AK $309KY $79.43
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.