How much rates vary
Facilitymedian $339 · 10th to 90th $151 to $724Professionalmedian $631 · 10th to 90th $398 to $759
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 $338.84 Median $630.96 Typical High $676.08 | Professional | None | $338.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $302.00 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $281.84 | $446.68 | $478.63 |
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 $562.34 Median $676.08 Typical High $794.33 | Professional | None | $562.34 | $676.08 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $512.86 | $602.56 | $724.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $549.54 |
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 $371.54 Median $457.09 Typical High $524.81 | Professional | None | $371.54 | $457.09 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $676.08 Typical High $5,495.41 | Facility | None | $316.23 | $676.08 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $741.31 | Professional | None | $446.68 | $630.96 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $302.00 | $478.63 | $512.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $281.84 | $446.68 | $478.63 |
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 $588.84 Median $616.60 Typical High $724.44 | Facility | None | $588.84 | $616.60 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $912.01 | Professional | None | $616.60 | $724.44 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $489.78 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $575.44 |
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 $588.84 Median $691.83 Typical High $812.83 | Professional | None | $588.84 | $691.83 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $363.08 | Facility | None | $281.84 | $346.74 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $489.78 | Professional | None | $151.36 | $346.74 | $489.78 |
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 $331.13 Median $457.09 Typical High $676.08 | Professional | None | $331.13 | $457.09 | $676.08 |
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 $204.17 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $81.28 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $61.66 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $63.10 | $67.61 |
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 $851.14 Median $1,000.00 Typical High $1,148.15 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $79.43 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $831.76 Typical High $954.99 | Professional | 63 · Small infant | $676.08 | $831.76 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $316.23 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $81.28 | $125.89 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $61.66 | $95.50 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $63.10 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 50 · Both sides | $1,047.13 | $1,047.13 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $75.86 |
Where Idaho sits
The same service costs 5.9 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
$631
AK $1,288UT $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.