How much rates vary
Facilitymedian $186 · 10th to 90th $87 to $479Professionalmedian $224 · 10th to 90th $155 to $302
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 Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $302.00 | Professional | None | $141.25 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $20.89 | $35.48 | $44.67 |
BCBS Idaho Setting Facility Modifier None Typical Low $95.50 Median $147.91 Typical High $416.87 | Facility | None | $95.50 | $147.91 | $416.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $309.03 | Professional | None | $181.97 | $251.19 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $120.23 | Facility | None | $77.62 | $87.10 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $223.87 | Professional | None | $151.36 | $177.83 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $426.58 | Facility | None | $134.90 | $234.42 | $426.58 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $302.00 | Professional | None | $158.49 | $239.88 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $20.89 | $35.48 | $44.67 |
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 $199.53 Median $199.53 Typical High $288.40 | Facility | None | $199.53 | $199.53 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $363.08 | Professional | None | $199.53 | $251.19 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $407.38 Typical High $512.86 | Facility | None | $275.42 | $407.38 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $354.81 | Professional | None | $223.87 | $275.42 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $316.23 | Facility | None | $134.90 | $138.04 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $190.55 | Professional | None | $79.43 | $134.90 | $190.55 |
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 $123.03 Median $177.83 Typical High $281.84 | Professional | None | $123.03 | $177.83 | $281.84 |
15 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 $70.79 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $70.79 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $28.18 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.13 | $23.44 | $30.20 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $138.04 Median $204.17 Typical High $707.95 | Facility | 50 · Both sides | $138.04 | $204.17 | $707.95 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $323.59 Typical High $478.63 | Professional | 50 · Both sides | $275.42 | $323.59 | $478.63 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $169.82 | $239.88 | $288.40 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $257.04 Typical High $389.05 | Professional | 63 · Small infant | $223.87 | $257.04 | $389.05 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $70.79 | $117.49 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $28.18 | $46.77 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.13 | $23.44 | $30.20 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $380.19 Typical High $489.78 | Professional | 50 · Both sides | $380.19 | $380.19 | $489.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $177.83 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $245.47 |
Where Idaho sits
The same service costs 4.3 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· 8th of 51
$224
AK $457KY $107
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.