How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,318 to $8,511Professionalmedian $1,318 · 10th to 90th $912 to $1,622
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $2,187.76 | $4,897.79 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,445.44 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $147.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,148.15 | Professional | None | $851.14 | $1,000.00 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $5,495.41 | Facility | None | $758.58 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $933.25 | $1,479.11 | $1,737.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
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 $1,071.52 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,071.52 | $1,318.26 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $10,715.19 | Facility | None | $5,495.41 | $8,317.64 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,479.11 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $7,943.28 | Facility | None | $630.96 | $645.65 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,862.09 | Professional | None | $630.96 | $741.31 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,548.82 | Professional | None | $741.31 | $1,047.13 | $1,548.82 |
9 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 $467.74 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $467.74 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $190.55 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $93.33 | $147.91 | $147.91 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $7,244.36 Typical High $14,454.40 | Facility | 50 · Both sides | $3,311.31 | $7,244.36 | $14,454.40 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,041.74 Typical High $2,238.72 | Professional | 50 · Both sides | $1,862.09 | $2,041.74 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,479.11 Median $1,659.59 Typical High $1,778.28 | Professional | 63 · Small infant | $1,479.11 | $1,659.59 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $467.74 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $190.55 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $93.33 | $147.91 | $147.91 |
Where Idaho sits
The same service costs 7.8 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· 9th of 51
$1,413
AK $3,020TX $389
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.