How much rates vary
Facilitymedian $1,349 · 10th to 90th $631 to $4,266Professionalmedian $562 · 10th to 90th $389 to $676
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 $354.81 Median $575.44 Typical High $660.69 | Professional | None | $354.81 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $269.15 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $251.19 | $407.38 | $457.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $4,168.69 | Facility | None | $1,174.90 | $2,290.87 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | None | $478.63 | $575.44 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $436.52 | $524.81 | $630.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $67.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $501.19 | Professional | None | $354.81 | $436.52 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $645.65 Typical High $5,495.41 | Facility | None | $302.00 | $645.65 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $676.08 | Professional | None | $407.38 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $269.15 | $436.52 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $87.10 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $251.19 | $407.38 | $457.09 |
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 $512.86 Median $524.81 Typical High $630.96 | Facility | None | $512.86 | $524.81 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $446.68 | $501.19 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $758.58 | Professional | None | $537.03 | $630.96 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $3,630.78 | Facility | None | $302.00 | $309.03 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $977.24 | Professional | None | $288.40 | $302.00 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
8 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 $177.83 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $177.83 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $70.79 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $35.48 | $57.54 | $64.57 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $575.44 Median $691.83 Typical High $812.83 | Professional | 63 · Small infant | $575.44 | $691.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $177.83 | $288.40 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $70.79 | $114.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $35.48 | $57.54 | $64.57 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $70.79 |
Where Idaho sits
The same service costs 6.8 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
$562
AK $1,288UT $191
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.