How much rates vary
Facilitymedian $282 · 10th to 90th $151 to $708Professionalmedian $417 · 10th to 90th $263 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 $501.19 Median $1,412.54 Typical High $7,079.46 | Facility | None | $501.19 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $478.63 | Professional | None | $229.09 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $204.17 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $40.74 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $190.55 | $295.12 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $707.95 | Facility | None | $141.25 | $251.19 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $501.19 | Professional | None | $371.54 | $436.52 | $501.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $363.08 | $398.11 | $467.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $47.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $346.74 |
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 $239.88 Median $302.00 Typical High $338.84 | Professional | None | $239.88 | $302.00 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $446.68 Typical High $4,466.84 | Facility | None | $223.87 | $446.68 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $512.86 | Professional | None | $288.40 | $416.87 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $204.17 | $316.23 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $40.74 | $63.10 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $190.55 | $295.12 | $316.23 |
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 $371.54 Median $407.38 Typical High $457.09 | Facility | None | $371.54 | $407.38 | $457.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $575.44 | Professional | None | $407.38 | $457.09 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $331.13 | $346.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $371.54 |
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 $380.19 Median $446.68 Typical High $524.81 | Professional | None | $380.19 | $446.68 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $223.87 Typical High $338.84 | Facility | None | $218.78 | $223.87 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $323.59 | Professional | None | $151.36 | $218.78 | $323.59 |
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 $218.78 Median $302.00 Typical High $436.52 | Professional | None | $218.78 | $302.00 | $436.52 |
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 $134.90 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $134.90 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $53.70 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $44.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $524.81 Typical High $602.56 | Professional | 63 · Small infant | $446.68 | $524.81 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $134.90 | $208.93 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $53.70 | $85.11 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $50.12 |
Where Idaho sits
The same service costs 5.1 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· 7th of 51
$417
AK $871UT $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.