How much rates vary
Facilitymedian $4,898 · 10th to 90th $457 to $14,454Professionalmedian $427 · 10th to 90th $257 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 $234.42 Median $371.54 Typical High $676.08 | Professional | None | $234.42 | $371.54 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $263.03 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $162.18 | $263.03 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $4,897.79 Typical High $18,620.87 | Facility | None | $1,819.70 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $691.83 | Professional | None | $316.23 | $478.63 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $407.38 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $223.87 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $7,762.47 | Facility | None | $5,128.61 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $524.81 | Professional | None | $251.19 | $338.84 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $537.03 Typical High $5,495.41 | Facility | None | $234.42 | $537.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $676.08 | Professional | None | $288.40 | $436.52 | $676.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $263.03 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $162.18 | $263.03 | $467.74 |
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 $346.74 Median $346.74 Typical High $630.96 | Facility | None | $346.74 | $346.74 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $794.33 | Professional | None | $346.74 | $436.52 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $794.33 | Professional | None | $371.54 | $446.68 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $6,918.31 | Facility | None | $302.00 | $309.03 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $5,248.07 | Professional | None | $186.21 | $302.00 | $5,248.07 |
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 $199.53 Median $371.54 Typical High $660.69 | Professional | None | $199.53 | $371.54 | $660.69 |
20 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 $117.49 Median $186.21 Typical High $338.84 | Professional | 52 · Reduced service | $117.49 | $186.21 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $74.13 Typical High $134.90 | Professional | 53 · Discontinued | $46.77 | $74.13 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $281.84 Typical High $501.19 | Professional | 54 · Surgery only | $173.78 | $281.84 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $56.23 Typical High $102.33 | Professional | 55 · Aftercare only | $34.67 | $56.23 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $37.15 Typical High $67.61 | Professional | 56 · Pre-op care only | $23.44 | $37.15 | $67.61 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $2,754.23 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $575.44 Typical High $1,000.00 | Professional | 50 · Both sides | $478.63 | $575.44 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $295.12 | $524.81 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $31.62 | $58.88 | $70.79 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | 62 · Two surgeons | $199.53 | $239.88 | $446.68 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $380.19 Median $446.68 Typical High $851.14 | Professional | 63 · Small infant | $380.19 | $446.68 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $186.21 Typical High $338.84 | Professional | 52 · Reduced service | $117.49 | $186.21 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $74.13 Typical High $134.90 | Professional | 53 · Discontinued | $46.77 | $74.13 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $281.84 Typical High $501.19 | Professional | 54 · Surgery only | $173.78 | $281.84 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $56.23 Typical High $102.33 | Professional | 55 · Aftercare only | $34.67 | $56.23 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $37.15 Typical High $67.61 | Professional | 56 · Pre-op care only | $23.44 | $37.15 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | 50 · Both sides | $616.60 | $616.60 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $512.86 | Professional | 54 · Surgery only | $288.40 | $288.40 | $512.86 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $74.13 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $74.13 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | 62 · Two surgeons | $257.04 | $257.04 | $457.09 |
Where Idaho sits
The same service costs 5.1 times more in Alaska than in Texas. 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· 11th of 51
$437
AK $977TX $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.