How much rates vary
Facilitymedian $363 · 10th to 90th $204 to $1,622Professionalmedian $479 · 10th to 90th $372 to $692
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $549.54 | Professional | None | $354.81 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $309.03 | $407.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $1,621.81 | Facility | None | $218.78 | $331.13 | $1,621.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $741.31 | Professional | None | $407.38 | $501.19 | $741.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $446.68 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $323.59 | Facility | None | $208.93 | $234.42 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $562.34 | Professional | None | $338.84 | $426.58 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $467.74 Typical High $5,495.41 | Facility | None | $309.03 | $467.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $691.83 | Professional | None | $371.54 | $524.81 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $309.03 | $407.38 |
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 $363.08 Median $380.19 Typical High $588.84 | Facility | None | $363.08 | $380.19 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $691.83 | Professional | None | $380.19 | $457.09 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $323.59 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $691.83 | Professional | None | $407.38 | $524.81 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $338.84 Typical High $707.95 | Facility | None | $331.13 | $338.84 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $457.09 | Professional | None | $331.13 | $331.13 | $457.09 |
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 $302.00 Median $416.87 Typical High $588.84 | Professional | None | $302.00 | $416.87 | $588.84 |
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 $204.17 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $380.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $66.07 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $724.44 Typical High $933.25 | Professional | 63 · Small infant | $489.78 | $724.44 | $933.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $338.84 | $426.58 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $204.17 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $83.18 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $60.26 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $457.09 |
Where Idaho sits
The same service costs 4.0 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· 10th of 51
$457
AK $1,096TX $275
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.