How much rates vary
Facilitymedian $537 · 10th to 90th $141 to $3,890Professionalmedian $209 · 10th to 90th $138 to $331
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $363.08 | Professional | None | $141.25 | $245.47 | $363.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $147.91 Median $660.69 Typical High $3,981.07 | Facility | None | $147.91 | $660.69 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $331.13 | Professional | None | $173.78 | $229.09 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $190.55 | Facility | None | $125.89 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $234.42 | Professional | None | $138.04 | $169.82 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $245.47 Typical High $4,466.84 | Facility | None | $107.15 | $245.47 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $363.08 | Professional | None | $158.49 | $245.47 | $363.08 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $302.00 | Facility | None | $186.21 | $186.21 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $302.00 | Professional | None | $186.21 | $229.09 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $302.00 | Professional | None | $199.53 | $218.78 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $2,089.30 | Facility | None | $144.54 | $147.91 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $190.55 | Professional | None | $120.23 | $144.54 | $190.55 |
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 $107.15 Median $169.82 Typical High $281.84 | Professional | None | $107.15 | $169.82 | $281.84 |
16 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 $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $70.79 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $50.12 Typical High $74.13 | Professional | 53 · Discontinued | $28.18 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $107.15 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $21.38 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $173.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $100.00 | $173.78 | $257.04 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $154.88 | $181.97 | $257.04 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $251.19 Typical High $389.05 | Professional | 63 · Small infant | $213.80 | $251.19 | $389.05 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $120.23 | $141.25 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $70.79 | $123.03 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $50.12 Typical High $74.13 | Professional | 53 · Discontinued | $28.18 | $50.12 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $107.15 | $186.21 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $21.38 | $37.15 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $36.31 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $173.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $100.00 | $173.78 | $257.04 |
Where Idaho sits
The same service costs 4.4 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· 13th of 51
$219
AK $417KY $95.50
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.