How much rates vary
Facilitymedian $575 · 10th to 90th $229 to $4,266Professionalmedian $355 · 10th to 90th $224 to $537
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 $208.93 Median $338.84 Typical High $537.03 | Professional | None | $208.93 | $338.84 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $251.19 Typical High $407.38 | Professional | 54 · Surgery only | $158.49 | $251.19 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $234.42 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $147.91 | $234.42 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $239.88 Median $1,380.38 Typical High $4,897.79 | Facility | None | $239.88 | $1,380.38 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $549.54 | Professional | None | $269.15 | $389.05 | $549.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $467.74 | Professional | 54 · Surgery only | $239.88 | $295.12 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $331.13 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $186.21 | $331.13 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $309.03 | Facility | None | $204.17 | $229.09 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $478.63 Typical High $5,495.41 | Facility | None | $138.04 | $478.63 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $537.03 | Professional | None | $245.47 | $389.05 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $251.19 Typical High $407.38 | Professional | 54 · Surgery only | $158.49 | $251.19 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $234.42 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $147.91 | $234.42 | $380.19 |
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 $288.40 Median $288.40 Typical High $512.86 | Facility | None | $288.40 | $288.40 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $645.65 | Professional | None | $288.40 | $363.08 | $645.65 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $251.19 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $426.58 |
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 $331.13 Median $389.05 Typical High $616.60 | Professional | None | $331.13 | $389.05 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $2,818.38 | Facility | None | $239.88 | $245.47 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $323.59 | Professional | None | $165.96 | $239.88 | $323.59 |
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 $177.83 Median $281.84 Typical High $478.63 | Professional | None | $177.83 | $281.84 | $478.63 |
14 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 $104.71 Median $165.96 Typical High $269.15 | Professional | 52 · Reduced service | $104.71 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $67.61 Typical High $107.15 | Professional | 53 · Discontinued | $42.66 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $50.12 Typical High $81.28 | Professional | 55 · Aftercare only | $31.62 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.88 Typical High $53.70 | Professional | 56 · Pre-op care only | $20.89 | $33.88 | $53.70 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $363.08 Median $1,905.46 Typical High $7,413.10 | Facility | 50 · Both sides | $363.08 | $1,905.46 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $707.95 Typical High $831.76 | Professional | 50 · Both sides | $416.87 | $707.95 | $831.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $54.95 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $54.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $380.19 Typical High $660.69 | Professional | 63 · Small infant | $323.59 | $380.19 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $165.96 Typical High $269.15 | Professional | 52 · Reduced service | $104.71 | $165.96 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $67.61 Typical High $107.15 | Professional | 53 · Discontinued | $42.66 | $67.61 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $50.12 Typical High $81.28 | Professional | 55 · Aftercare only | $31.62 | $50.12 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.88 Typical High $53.70 | Professional | 56 · Pre-op care only | $20.89 | $33.88 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $549.54 Typical High $851.14 | Professional | 50 · Both sides | $549.54 | $549.54 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $57.54 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in Utah. 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
$355
AK $692UT $186
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.