How much rates vary
Facilitymedian $191 · 10th to 90th $126 to $603Professionalmedian $195 · 10th to 90th $145 to $316
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 $117.49 Median $158.49 Typical High $251.19 | Professional | None | $117.49 | $158.49 | $251.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $512.86 | Facility | None | $120.23 | $190.55 | $512.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $338.84 | Professional | None | $162.18 | $218.78 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $131.83 Typical High $177.83 | Facility | None | $117.49 | $131.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $263.03 | Professional | None | $144.54 | $181.97 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $223.87 Typical High $5,495.41 | Facility | None | $109.65 | $223.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $323.59 | Professional | None | $147.91 | $204.17 | $323.59 |
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 $144.54 Median $151.36 Typical High $269.15 | Facility | None | $144.54 | $151.36 | $269.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $316.23 | Professional | None | $151.36 | $190.55 | $316.23 |
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 $162.18 Median $208.93 Typical High $323.59 | Professional | None | $162.18 | $208.93 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $354.81 | Facility | None | $151.36 | $154.88 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | None | $151.36 | $151.36 | $213.80 |
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 $114.82 Median $177.83 Typical High $275.42 | Professional | None | $114.82 | $177.83 | $275.42 |
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 $79.43 Median $79.43 Typical High $125.89 | Professional | 52 · Reduced service | $79.43 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $50.12 | Professional | 53 · Discontinued | $31.62 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $190.55 | Professional | 54 · Surgery only | $120.23 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $177.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $309.03 | Professional | 54 · Surgery only | $144.54 | $169.82 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $35.48 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $35.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $194.98 Median $213.80 Typical High $426.58 | Professional | 63 · Small infant | $194.98 | $213.80 | $426.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $112.20 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $125.89 | Professional | 52 · Reduced service | $79.43 | $79.43 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $50.12 | Professional | 53 · Discontinued | $31.62 | $31.62 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $190.55 | Professional | 54 · Surgery only | $120.23 | $120.23 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $25.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $125.89 | $125.89 | $199.53 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $28.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $213.80 |
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
$195
AK $427KY $123
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.