How much rates vary
Facilitymedian $912 · 10th to 90th $324 to $4,266Professionalmedian $372 · 10th to 90th $240 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 $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 $223.87 Median $354.81 Typical High $562.34 | Professional | None | $223.87 | $354.81 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $269.15 Typical High $416.87 | Professional | 54 · Surgery only | $169.82 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $251.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $158.49 | $251.19 | $389.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $4,897.79 | Facility | None | $616.60 | $1,348.96 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $575.44 | Professional | None | $295.12 | $407.38 | $575.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $309.03 Typical High $512.86 | Professional | 54 · Surgery only | $257.04 | $309.03 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $275.42 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $204.17 | $275.42 | $398.11 |
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 $234.42 Median $309.03 Typical High $436.52 | Professional | None | $234.42 | $309.03 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $512.86 Typical High $5,495.41 | Facility | None | $147.91 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $562.34 | Professional | None | $263.03 | $416.87 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $269.15 Typical High $416.87 | Professional | 54 · Surgery only | $169.82 | $269.15 | $416.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $251.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $158.49 | $251.19 | $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 $309.03 Median $309.03 Typical High $537.03 | Facility | None | $309.03 | $309.03 | $537.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $676.08 | Professional | None | $309.03 | $389.05 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $275.42 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $457.09 |
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 $354.81 Median $416.87 Typical High $660.69 | Professional | None | $354.81 | $416.87 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $2,137.96 | Facility | None | $257.04 | $257.04 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $831.76 | Professional | None | $177.83 | $257.04 | $831.76 |
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 $194.98 Median $302.00 Typical High $501.19 | Professional | None | $194.98 | $302.00 | $501.19 |
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 $112.20 Median $177.83 Typical High $281.84 | Professional | 52 · Reduced service | $112.20 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $70.79 Typical High $112.20 | Professional | 53 · Discontinued | $44.67 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $53.70 Typical High $85.11 | Professional | 55 · Aftercare only | $33.88 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $35.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $22.39 | $35.48 | $56.23 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,949.84 Typical High $7,413.10 | Facility | 50 · Both sides | $891.25 | $1,949.84 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $741.31 Typical High $870.96 | Professional | 50 · Both sides | $426.58 | $741.31 | $870.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $28.18 | $48.98 | $60.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $338.84 Median $575.44 Typical High $724.44 | Professional | 63 · Small infant | $338.84 | $575.44 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $177.83 Typical High $281.84 | Professional | 52 · Reduced service | $112.20 | $177.83 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $70.79 Typical High $112.20 | Professional | 53 · Discontinued | $44.67 | $70.79 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $53.70 Typical High $85.11 | Professional | 55 · Aftercare only | $33.88 | $53.70 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $35.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $22.39 | $35.48 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $588.84 Typical High $912.01 | Professional | 50 · Both sides | $588.84 | $588.84 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $60.26 |
Where Idaho sits
The same service costs 4.1 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· 10th of 51
$380
AK $851TX $209
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.