How much rates vary
Facilitymedian $339 · 10th to 90th $151 to $708Professionalmedian $617 · 10th to 90th $389 to $741
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 $346.74 Median $616.60 Typical High $660.69 | Professional | None | $346.74 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $707.95 | Facility | None | $144.54 | $263.03 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $776.25 | Professional | None | $549.54 | $645.65 | $776.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $501.19 | $602.56 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $537.03 |
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 $363.08 Median $446.68 Typical High $512.86 | Professional | None | $363.08 | $446.68 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $660.69 Typical High $5,495.41 | Facility | None | $309.03 | $660.69 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $741.31 | Professional | None | $436.52 | $616.60 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $467.74 | $501.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $467.74 |
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 $575.44 Median $602.56 Typical High $707.95 | Facility | None | $575.44 | $602.56 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $891.25 | Professional | None | $602.56 | $707.95 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $478.63 | $524.81 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $562.34 |
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 $575.44 Median $676.08 Typical High $794.33 | Professional | None | $575.44 | $676.08 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $354.81 | Facility | None | $281.84 | $338.84 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $478.63 | Professional | None | $151.36 | $338.84 | $478.63 |
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 $323.59 Median $446.68 Typical High $645.65 | Professional | None | $323.59 | $446.68 | $645.65 |
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 $199.53 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $199.53 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $60.26 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $66.07 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $218.78 Median $380.19 Typical High $1,071.52 | Facility | 50 · Both sides | $218.78 | $380.19 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $977.24 Typical High $1,148.15 | Professional | 50 · Both sides | $831.76 | $977.24 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $77.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $794.33 Typical High $954.99 | Professional | 63 · Small infant | $676.08 | $794.33 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $199.53 | $309.03 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $123.03 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $60.26 | $93.33 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | 50 · Both sides | $1,023.29 | $1,023.29 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $74.13 |
Where Idaho sits
The same service costs 5.8 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· 8th of 51
$617
AK $1,259UT $219
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.