How much rates vary
Facilitymedian $302 · 10th to 90th $148 to $708Professionalmedian $537 · 10th to 90th $339 to $661
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 $309.03 Median $537.03 Typical High $588.84 | Professional | None | $309.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $257.04 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $239.88 | $371.54 | $416.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $245.47 Typical High $616.60 | Facility | None | $109.65 | $245.47 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $691.83 | Professional | None | $489.78 | $575.44 | $691.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $436.52 | $537.03 | $630.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $457.09 | Professional | None | $316.23 | $398.11 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $588.84 Typical High $5,495.41 | Facility | None | $251.19 | $588.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $676.08 | Professional | None | $389.05 | $549.54 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $257.04 | $398.11 | $446.68 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $239.88 | $371.54 | $416.87 |
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 $524.81 Median $524.81 Typical High $645.65 | Facility | None | $524.81 | $524.81 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $812.83 | Professional | None | $524.81 | $645.65 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $416.87 | $467.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $707.95 | Professional | None | $512.86 | $602.56 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $302.00 Typical High $338.84 | Facility | None | $281.84 | $302.00 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $416.87 | Professional | None | $151.36 | $302.00 | $416.87 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $549.54 | Professional | None | $269.15 | $380.19 | $549.54 |
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 $169.82 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $69.18 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $58.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $162.18 Median $363.08 Typical High $912.01 | Facility | 50 · Both sides | $162.18 | $363.08 | $912.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $851.14 Typical High $1,071.52 | Professional | 50 · Both sides | $724.44 | $851.14 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $69.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $588.84 Median $691.83 Typical High $812.83 | Professional | 63 · Small infant | $588.84 | $691.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $263.03 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $69.18 | $107.15 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $891.25 Typical High $1,000.00 | Professional | 50 · Both sides | $891.25 | $891.25 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $66.07 |
Where Idaho sits
The same service costs 5.4 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· 8th of 51
$537
AK $1,096TX $204
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.