How much rates vary
Facilitymedian $479 · 10th to 90th $229 to $4,169Professionalmedian $355 · 10th to 90th $219 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 $204.17 Median $323.59 Typical High $524.81 | Professional | None | $204.17 | $323.59 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $245.47 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $245.47 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $229.09 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $144.54 | $229.09 | $371.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $239.88 Median $954.99 Typical High $4,265.80 | Facility | None | $239.88 | $954.99 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $549.54 | Professional | None | $263.03 | $389.05 | $549.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $416.87 Typical High $501.19 | Professional | 54 · Surgery only | $234.42 | $416.87 | $501.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $316.23 | Facility | None | $204.17 | $229.09 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $407.38 | Professional | None | $213.80 | $281.84 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $467.74 Typical High $5,495.41 | Facility | None | $190.55 | $467.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $524.81 | Professional | None | $239.88 | $380.19 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $245.47 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $245.47 | $398.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $229.09 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $144.54 | $229.09 | $371.54 |
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 $512.86 | Facility | None | $281.84 | $281.84 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $645.65 | Professional | None | $281.84 | $354.81 | $645.65 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $245.47 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $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 $316.23 Median $380.19 Typical High $616.60 | Professional | None | $316.23 | $380.19 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $1,479.11 | Facility | None | $239.88 | $245.47 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $323.59 | Professional | None | $158.49 | $239.88 | $323.59 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $467.74 | Professional | None | $173.78 | $281.84 | $467.74 |
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 $102.33 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $102.33 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $104.71 | Professional | 53 · Discontinued | $40.74 | $64.57 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $48.98 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $48.98 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $52.48 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $363.08 Median $1,258.93 Typical High $6,309.57 | Facility | 50 · Both sides | $363.08 | $1,258.93 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $524.81 Typical High $831.76 | Professional | 50 · Both sides | $407.38 | $524.81 | $831.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $31.62 Typical High $53.70 | Professional | 55 · Aftercare only | $26.30 | $31.62 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $380.19 Typical High $630.96 | Professional | 63 · Small infant | $323.59 | $380.19 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $102.33 | $162.18 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $104.71 | Professional | 53 · Discontinued | $40.74 | $64.57 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $48.98 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $48.98 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $524.81 Typical High $851.14 | Professional | 50 · Both sides | $524.81 | $524.81 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $56.23 |
Where Idaho sits
The same service costs 3.5 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· 10th of 51
$355
AK $646KY $182
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.