How much rates vary
Facilitymedian $257 · 10th to 90th $170 to $1,047Professionalmedian $309 · 10th to 90th $229 to $468
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 $213.80 Median $257.04 Typical High $371.54 | Professional | None | $213.80 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $177.83 | $263.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $1,047.13 | Facility | None | $199.53 | $346.74 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $512.86 | Professional | None | $257.04 | $323.59 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $177.83 Typical High $245.47 | Facility | None | $158.49 | $177.83 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $389.05 | Professional | None | $213.80 | $275.42 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $323.59 Typical High $5,495.41 | Facility | None | $181.97 | $323.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $177.83 | $263.03 |
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 $223.87 Median $234.42 Typical High $398.11 | Facility | None | $223.87 | $234.42 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $467.74 | Professional | None | $234.42 | $288.40 | $467.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $467.74 | Professional | None | $257.04 | $323.59 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $676.08 | Facility | None | $223.87 | $229.09 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $316.23 | Professional | None | $223.87 | $223.87 | $316.23 |
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 $186.21 Median $263.03 Typical High $407.38 | Professional | None | $186.21 | $263.03 | $407.38 |
15 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 $128.82 Median $128.82 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $190.55 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $37.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $257.04 | $389.05 | $457.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $51.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $302.00 Median $354.81 Typical High $616.60 | Professional | 63 · Small infant | $302.00 | $354.81 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $128.82 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $51.29 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $190.55 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $37.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $199.53 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $41.69 |
Where Idaho sits
The same service costs 3.5 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· 11th of 51
$309
AK $676TX $191
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.