How much rates vary
Facilitymedian $295 · 10th to 90th $141 to $631Professionalmedian $204 · 10th to 90th $151 to $324
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $275.42 | Professional | None | $123.03 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $190.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $316.23 Typical High $602.56 | Facility | None | $112.20 | $316.23 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $363.08 | Professional | None | $169.82 | $234.42 | $363.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $338.84 | Professional | 54 · Surgery only | $151.36 | $169.82 | $338.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $144.54 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $117.49 | $144.54 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $281.84 | Professional | None | $151.36 | $199.53 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $165.96 Typical High $4,466.84 | Facility | None | $114.82 | $165.96 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $346.74 | Professional | None | $154.88 | $213.80 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $125.89 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $190.55 |
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 $147.91 Median $158.49 Typical High $288.40 | Facility | None | $147.91 | $158.49 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $338.84 | Professional | None | $158.49 | $204.17 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $213.80 | Professional | 54 · Surgery only | $131.83 | $131.83 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $229.09 |
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 $169.82 Median $223.87 Typical High $346.74 | Professional | None | $169.82 | $223.87 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $354.81 | Facility | None | $162.18 | $165.96 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | None | $162.18 | $162.18 | $229.09 |
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 $120.23 Median $190.55 Typical High $295.12 | Professional | None | $120.23 | $190.55 | $295.12 |
11 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 $83.18 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $83.18 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $54.95 | Professional | 53 · Discontinued | $33.11 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $27.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $16.98 | $30.20 | $38.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $204.17 Median $245.47 Typical High $416.87 | Professional | 63 · Small infant | $204.17 | $245.47 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $83.18 Typical High $134.90 | Professional | 52 · Reduced service | $83.18 | $83.18 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $54.95 | Professional | 53 · Discontinued | $33.11 | $33.11 | $54.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $27.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $30.20 |
Where Idaho sits
The same service costs 3.4 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· 11th of 51
$214
AK $447KY $132
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.