How much rates vary
Facilitymedian $912 · 10th to 90th $158 to $4,266Professionalmedian $148 · 10th to 90th $93 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 $85.11 Median $131.83 Typical High $234.42 | Professional | None | $85.11 | $131.83 | $234.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $371.54 Median $1,000.00 Typical High $4,265.80 | Facility | None | $371.54 | $1,000.00 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $338.84 | Professional | None | $104.71 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $245.47 | Professional | None | $95.50 | $165.96 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $151.36 Typical High $5,495.41 | Facility | None | $79.43 | $151.36 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $288.40 | Professional | None | $93.33 | $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 $107.15 Median $107.15 Typical High $288.40 | Facility | None | $107.15 | $107.15 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $316.23 | Professional | None | $107.15 | $204.17 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $257.04 | Professional | None | $104.71 | $138.04 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $954.99 | Facility | None | $147.91 | $151.36 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $181.97 | Professional | None | $75.86 | $147.91 | $181.97 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $263.03 | Professional | None | $77.62 | $144.54 | $263.03 |
16 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 $42.66 Median $52.48 Typical High $117.49 | Professional | 52 · Reduced service | $42.66 | $52.48 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.89 Typical High $46.77 | Professional | 53 · Discontinued | $17.38 | $20.89 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $77.62 Typical High $173.78 | Professional | 54 · Surgery only | $64.57 | $77.62 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $34.67 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.47 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.51 | $10.47 | $23.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $512.86 Median $1,479.11 Typical High $6,309.57 | Facility | 50 · Both sides | $512.86 | $1,479.11 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $436.52 Typical High $524.81 | Professional | 50 · Both sides | $181.97 | $436.52 | $524.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $97.72 | $251.19 | $316.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.59 Typical High $28.18 | Professional | 55 · Aftercare only | $10.72 | $12.59 | $28.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $128.82 Median $151.36 Typical High $354.81 | Professional | 63 · Small infant | $128.82 | $151.36 | $354.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $91.20 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $75.86 | $91.20 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $52.48 Typical High $117.49 | Professional | 52 · Reduced service | $42.66 | $52.48 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.89 Typical High $46.77 | Professional | 53 · Discontinued | $17.38 | $20.89 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $77.62 Typical High $173.78 | Professional | 54 · Surgery only | $64.57 | $77.62 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $34.67 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.47 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.51 | $10.47 | $23.44 |
Where Idaho sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 9th of 51
$224
AK $437HI $89.13
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.