How much rates vary
Facilitymedian $1,230 · 10th to 90th $339 to $4,266Professionalmedian $589 · 10th to 90th $398 to $891
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 $363.08 Median $588.84 Typical High $891.25 | Professional | None | $363.08 | $588.84 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $269.15 | $436.52 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $407.38 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $251.19 | $407.38 | $616.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $371.54 Median $1,778.28 Typical High $4,168.69 | Facility | None | $371.54 | $1,778.28 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $912.01 | Professional | None | $489.78 | $645.65 | $912.01 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $812.83 | Professional | 54 · Surgery only | $436.52 | $524.81 | $812.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $446.68 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $346.74 | $446.68 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $338.84 Typical High $457.09 | Facility | None | $302.00 | $338.84 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $691.83 | Professional | None | $371.54 | $489.78 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $4,466.84 | Facility | None | $398.11 | $851.14 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $891.25 | Professional | None | $446.68 | $691.83 | $891.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $269.15 | $436.52 | $660.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $407.38 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $251.19 | $407.38 | $616.60 |
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 $524.81 Median $524.81 Typical High $831.76 | Facility | None | $524.81 | $524.81 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,071.52 | Professional | None | $524.81 | $676.08 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $446.68 | $446.68 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $724.44 |
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 $575.44 Median $691.83 Typical High $1,047.13 | Professional | None | $575.44 | $691.83 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $3,630.78 | Facility | None | $398.11 | $407.38 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $549.54 | Professional | None | $295.12 | $398.11 | $549.54 |
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 $478.63 Typical High $851.14 | Professional | None | $309.03 | $478.63 | $851.14 |
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 $181.97 Median $295.12 Typical High $446.68 | Professional | 52 · Reduced service | $181.97 | $295.12 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $117.49 Typical High $177.83 | Professional | 53 · Discontinued | $72.44 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $89.13 Typical High $131.83 | Professional | 55 · Aftercare only | $54.95 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $58.88 Typical High $89.13 | Professional | 56 · Pre-op care only | $36.31 | $58.88 | $89.13 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $549.54 Median $2,691.53 Typical High $6,760.83 | Facility | 50 · Both sides | $549.54 | $2,691.53 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,071.52 Typical High $1,348.96 | Professional | 50 · Both sides | $794.33 | $1,071.52 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $57.54 Typical High $87.10 | Professional | 55 · Aftercare only | $48.98 | $57.54 | $87.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $588.84 Median $691.83 Typical High $1,071.52 | Professional | 63 · Small infant | $588.84 | $691.83 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $295.12 Typical High $446.68 | Professional | 52 · Reduced service | $181.97 | $295.12 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $117.49 Typical High $177.83 | Professional | 53 · Discontinued | $72.44 | $117.49 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $89.13 Typical High $131.83 | Professional | 55 · Aftercare only | $54.95 | $89.13 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $58.88 Typical High $89.13 | Professional | 56 · Pre-op care only | $36.31 | $58.88 | $89.13 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $977.24 Typical High $1,445.44 | Professional | 50 · Both sides | $977.24 | $977.24 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $95.50 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $95.50 |
Where Idaho sits
The same service costs 4.7 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· 10th of 51
$589
AK $1,175UT $251
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.