How much rates vary
Facilitymedian $182 · 10th to 90th $117 to $603Professionalmedian $182 · 10th to 90th $132 to $288
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 $125.89 Median $144.54 Typical High $229.09 | Professional | None | $125.89 | $144.54 | $229.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $186.21 Typical High $512.86 | Facility | None | $120.23 | $186.21 | $512.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $309.03 | Professional | None | $147.91 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $120.23 Typical High $165.96 | Facility | None | $107.15 | $120.23 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $234.42 | Professional | None | $131.83 | $165.96 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $199.53 Typical High $5,495.41 | Facility | None | $97.72 | $199.53 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $288.40 | Professional | None | $134.90 | $181.97 | $288.40 |
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 $128.82 Median $138.04 Typical High $245.47 | Facility | None | $128.82 | $138.04 | $245.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $288.40 | Professional | None | $138.04 | $169.82 | $288.40 |
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 $147.91 Median $186.21 Typical High $288.40 | Professional | None | $147.91 | $186.21 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $354.81 | Facility | None | $138.04 | $138.04 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
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 $104.71 Median $162.18 Typical High $251.19 | Professional | None | $104.71 | $162.18 | $251.19 |
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 $72.44 Median $72.44 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $100.00 | $158.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $281.84 | Professional | 54 · Surgery only | $131.83 | $154.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $14.79 | $25.70 | $30.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $177.83 Median $213.80 Typical High $354.81 | Professional | 63 · Small infant | $177.83 | $213.80 | $354.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $125.89 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $102.33 | $125.89 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $72.44 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $28.84 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $107.15 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $22.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $100.00 | $158.49 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $114.82 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $25.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $190.55 |
Where Idaho sits
The same service costs 3.5 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· 12th of 51
$182
AK $389KY $110
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.