How much rates vary
Facilitymedian $1,000 · 10th to 90th $380 to $4,169Professionalmedian $347 · 10th to 90th $214 to $562
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 $380.19 Median $660.69 Typical High $5,495.41 | Facility | None | $380.19 | $660.69 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $549.54 | Professional | None | $199.53 | $316.23 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $416.87 | Professional | 54 · Surgery only | $151.36 | $239.88 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $83.18 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $389.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $4,265.80 | Facility | None | $1,000.00 | $2,238.72 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $575.44 | Professional | None | $269.15 | $398.11 | $575.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $489.78 | Professional | 54 · Surgery only | $234.42 | $281.84 | $489.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $47.86 Typical High $58.88 | Professional | 55 · Aftercare only | $25.70 | $47.86 | $58.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $338.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $181.97 | $338.84 | $416.87 |
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 $213.80 Median $275.42 Typical High $426.58 | Professional | None | $213.80 | $275.42 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $660.69 Typical High $3,890.45 | Facility | None | $251.19 | $660.69 | $3,890.45 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $549.54 | Professional | None | $234.42 | $380.19 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $416.87 | Professional | 54 · Surgery only | $151.36 | $239.88 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $83.18 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $389.05 |
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 $281.84 Median $281.84 Typical High $524.81 | Facility | None | $281.84 | $281.84 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $660.69 | Professional | None | $281.84 | $354.81 | $660.69 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | 54 · Surgery only | $239.88 | $239.88 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $446.68 |
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 $316.23 Median $380.19 Typical High $645.65 | Professional | None | $316.23 | $380.19 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $2,818.38 | Facility | None | $251.19 | $257.04 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $831.76 | Professional | None | $154.88 | $251.19 | $831.76 |
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 $169.82 Median $281.84 Typical High $478.63 | Professional | None | $169.82 | $281.84 | $478.63 |
8 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 $100.00 Median $158.49 Typical High $275.42 | Professional | 52 · Reduced service | $100.00 | $158.49 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $64.57 Typical High $109.65 | Professional | 53 · Discontinued | $39.81 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $54.95 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $54.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $309.03 Median $371.54 Typical High $676.08 | Professional | 63 · Small infant | $309.03 | $371.54 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $158.49 Typical High $275.42 | Professional | 52 · Reduced service | $100.00 | $158.49 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $64.57 Typical High $109.65 | Professional | 53 · Discontinued | $39.81 | $64.57 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $54.95 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $58.88 |
Where Idaho sits
The same service costs 4.5 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· 11th of 51
$363
AK $759KY $170
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.