How much rates vary
Facilitymedian $1,000 · 10th to 90th $562 to $4,467Professionalmedian $646 · 10th to 90th $437 to $955
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 $758.58 Median $1,122.02 Typical High $5,495.41 | Facility | None | $758.58 | $1,122.02 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $954.99 | Professional | None | $398.11 | $645.65 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $295.12 | $478.63 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $275.42 | $446.68 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $4,897.79 | Facility | None | $1,000.00 | $1,905.46 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $977.24 | Professional | None | $537.03 | $707.95 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $562.34 | $831.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $457.09 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $371.54 | $457.09 | $660.69 |
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 $416.87 Median $524.81 Typical High $741.31 | Professional | None | $416.87 | $524.81 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $4,466.84 | Facility | None | $407.38 | $758.58 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $954.99 | Professional | None | $478.63 | $758.58 | $954.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $295.12 | $478.63 | $707.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $275.42 | $446.68 | $660.69 |
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 $575.44 Typical High $891.25 | Facility | None | $575.44 | $575.44 | $891.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,122.02 | Professional | None | $575.44 | $724.44 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $707.95 | Professional | 54 · Surgery only | $489.78 | $489.78 | $707.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $758.58 |
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 $630.96 Median $758.58 Typical High $1,096.48 | Professional | None | $630.96 | $758.58 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $5,370.32 | Facility | None | $426.58 | $436.52 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $831.76 | Professional | None | $316.23 | $426.58 | $831.76 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $870.96 | Professional | None | $338.84 | $524.81 | $870.96 |
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 $323.59 Typical High $478.63 | Professional | 52 · Reduced service | $199.53 | $323.59 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $128.82 Typical High $190.55 | Professional | 53 · Discontinued | $79.43 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $141.25 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $64.57 Typical High $95.50 | Professional | 56 · Pre-op care only | $39.81 | $64.57 | $95.50 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,479.11 Median $2,818.38 Typical High $7,413.10 | Facility | 50 · Both sides | $1,479.11 | $2,818.38 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,202.26 Typical High $1,513.56 | Professional | 50 · Both sides | $831.76 | $1,202.26 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $70.79 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $70.79 | $97.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $1,000.00 Typical High $1,174.90 | Professional | 63 · Small infant | $645.65 | $1,000.00 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $323.59 Typical High $478.63 | Professional | 52 · Reduced service | $199.53 | $323.59 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $128.82 Typical High $190.55 | Professional | 53 · Discontinued | $79.43 | $128.82 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $141.25 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $64.57 Typical High $95.50 | Professional | 56 · Pre-op care only | $39.81 | $64.57 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,047.13 Typical High $1,513.56 | Professional | 50 · Both sides | $1,047.13 | $1,047.13 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $102.33 |
Where Idaho sits
The same service costs 4.9 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· 9th of 51
$661
AK $1,413UT $288
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.