How much rates vary
Facilitymedian $468 · 10th to 90th $209 to $1,820Professionalmedian $295 · 10th to 90th $186 to $501
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $501.19 | Professional | None | $169.82 | $275.42 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $371.54 | Professional | 54 · Surgery only | $128.82 | $204.17 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $190.55 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $120.23 | $190.55 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $812.83 Typical High $1,819.70 | Facility | None | $223.87 | $812.83 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $501.19 | Professional | None | $229.09 | $354.81 | $501.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $323.59 Typical High $457.09 | Professional | 54 · Surgery only | $208.93 | $323.59 | $457.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $208.93 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $162.18 | $208.93 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $281.84 | Facility | None | $181.97 | $208.93 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $398.11 | Professional | None | $181.97 | $251.19 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $501.19 Typical High $4,897.79 | Facility | None | $223.87 | $501.19 | $4,897.79 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $549.54 | Professional | None | $208.93 | $323.59 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $371.54 | Professional | 54 · Surgery only | $128.82 | $204.17 | $371.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $190.55 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $120.23 | $190.55 | $346.74 |
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 $251.19 Median $251.19 Typical High $467.74 | Facility | None | $251.19 | $251.19 | $467.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $588.84 | Professional | None | $251.19 | $316.23 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $371.54 | Professional | 54 · Surgery only | $208.93 | $208.93 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,819.70 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $575.44 | Professional | None | $269.15 | $323.59 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $1,318.26 | Facility | None | $223.87 | $229.09 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $302.00 | Professional | None | $134.90 | $208.93 | $302.00 |
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 $147.91 Median $275.42 Typical High $467.74 | Professional | None | $147.91 | $275.42 | $467.74 |
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 $85.11 Median $138.04 Typical High $251.19 | Professional | 52 · Reduced service | $85.11 | $138.04 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $54.95 Typical High $100.00 | Professional | 53 · Discontinued | $33.88 | $54.95 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $40.74 Typical High $74.13 | Professional | 55 · Aftercare only | $25.70 | $40.74 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $27.54 Typical High $50.12 | Professional | 56 · Pre-op care only | $16.98 | $27.54 | $50.12 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $331.13 Median $1,230.27 Typical High $3,162.28 | Facility | 50 · Both sides | $331.13 | $1,230.27 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $630.96 Typical High $776.25 | Professional | 50 · Both sides | $346.74 | $630.96 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $50.12 | Professional | 55 · Aftercare only | $22.91 | $28.18 | $50.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $338.84 Typical High $602.56 | Professional | 63 · Small infant | $275.42 | $338.84 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $138.04 Typical High $251.19 | Professional | 52 · Reduced service | $85.11 | $138.04 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $54.95 Typical High $100.00 | Professional | 53 · Discontinued | $33.88 | $54.95 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $40.74 Typical High $74.13 | Professional | 55 · Aftercare only | $25.70 | $40.74 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $27.54 Typical High $50.12 | Professional | 56 · Pre-op care only | $16.98 | $27.54 | $50.12 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $446.68 Typical High $794.33 | Professional | 50 · Both sides | $446.68 | $446.68 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $53.70 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $53.70 |
Where Idaho sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 9th of 51
$316
AK $617KY $170
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.