How much rates vary
Facilitymedian $288 · 10th to 90th $115 to $513Professionalmedian $263 · 10th to 90th $166 to $447
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 $363.08 Median $616.60 Typical High $4,466.84 | Facility | None | $363.08 | $616.60 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $302.00 Typical High $512.86 | Professional | None | $138.04 | $302.00 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $52.48 Median $204.17 Typical High $389.05 | Facility | None | $52.48 | $204.17 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $446.68 | Professional | None | $208.93 | $257.04 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $316.23 | Professional | None | $165.96 | $223.87 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $338.84 Typical High $616.60 | Facility | None | $194.98 | $338.84 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $512.86 | Professional | None | $173.78 | $302.00 | $512.86 |
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 $223.87 Median $223.87 Typical High $407.38 | Facility | None | $223.87 | $223.87 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $416.87 | Professional | None | $223.87 | $229.09 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $416.87 | Facility | None | $218.78 | $331.13 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $426.58 | Professional | None | $239.88 | $269.15 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $199.53 | Facility | None | $128.82 | $194.98 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $257.04 | Professional | None | $144.54 | $194.98 | $257.04 |
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 $218.78 Typical High $398.11 | Professional | None | $123.03 | $218.78 | $398.11 |
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 $87.10 Median $151.36 Typical High $257.04 | Professional | 52 · Reduced service | $87.10 | $151.36 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $60.26 Typical High $102.33 | Professional | 53 · Discontinued | $34.67 | $60.26 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $223.87 Typical High $380.19 | Professional | 54 · Surgery only | $128.82 | $223.87 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $45.71 Typical High $77.62 | Professional | 55 · Aftercare only | $25.70 | $45.71 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $30.20 Typical High $51.29 | Professional | 56 · Pre-op care only | $17.38 | $30.20 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $208.93 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $120.23 | $208.93 | $354.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $218.78 Typical High $380.19 | Professional | 54 · Surgery only | $190.55 | $218.78 | $380.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.12 Typical High $43.65 | Professional | 55 · Aftercare only | $21.38 | $25.12 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $457.09 Typical High $549.54 | Professional | 63 · Small infant | $275.42 | $457.09 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $269.15 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $162.18 | $269.15 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $151.36 Typical High $257.04 | Professional | 52 · Reduced service | $87.10 | $151.36 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $60.26 Typical High $102.33 | Professional | 53 · Discontinued | $34.67 | $60.26 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $229.09 Typical High $380.19 | Professional | 54 · Surgery only | $128.82 | $229.09 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $45.71 Typical High $77.62 | Professional | 55 · Aftercare only | $25.70 | $45.71 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $30.20 Typical High $51.29 | Professional | 56 · Pre-op care only | $17.38 | $30.20 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $208.93 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $120.23 | $208.93 | $354.81 |
Where Idaho sits
The same service costs 4.5 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· 10th of 51
$269
AK $501KY $112
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.