How much rates vary
Facilitymedian $288 · 10th to 90th $151 to $741Professionalmedian $240 · 10th to 90th $148 to $398
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 $316.23 Median $537.03 Typical High $5,495.41 | Facility | None | $316.23 | $537.03 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $446.68 | Professional | None | $117.49 | $263.03 | $446.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $309.03 Typical High $741.31 | Facility | None | $173.78 | $309.03 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $398.11 | Professional | None | $181.97 | $275.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $218.78 | Facility | None | $141.25 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | None | $147.91 | $204.17 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $380.19 Typical High $4,466.84 | Facility | None | $151.36 | $380.19 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $446.68 | Professional | None | $151.36 | $263.03 | $446.68 |
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 $199.53 Median $199.53 Typical High $363.08 | Facility | None | $199.53 | $199.53 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $363.08 | Professional | None | $199.53 | $245.47 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $794.33 | Facility | None | $407.38 | $588.84 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $371.54 | Professional | None | $213.80 | $234.42 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $851.14 | Facility | None | $173.78 | $177.83 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $234.42 | Professional | None | $125.89 | $173.78 | $234.42 |
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 $114.82 Median $194.98 Typical High $338.84 | Professional | None | $114.82 | $194.98 | $338.84 |
18 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 $75.86 Median $131.83 Typical High $223.87 | Professional | 52 · Reduced service | $75.86 | $131.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $30.20 | $52.48 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $199.53 Typical High $331.13 | Professional | 54 · Surgery only | $112.20 | $199.53 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $39.81 Typical High $67.61 | Professional | 55 · Aftercare only | $22.39 | $39.81 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $15.14 | $26.30 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $186.21 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $104.71 | $186.21 | $309.03 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $263.03 Median $436.52 Typical High $1,122.02 | Facility | 50 · Both sides | $263.03 | $436.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $323.59 Typical High $588.84 | Professional | 50 · Both sides | $281.84 | $323.59 | $588.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $295.12 Typical High $354.81 | Professional | 54 · Surgery only | $165.96 | $295.12 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.38 Typical High $40.74 | Professional | 55 · Aftercare only | $18.20 | $21.38 | $40.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $257.04 Typical High $478.63 | Professional | 63 · Small infant | $218.78 | $257.04 | $478.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $131.83 | $245.47 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $131.83 Typical High $223.87 | Professional | 52 · Reduced service | $75.86 | $131.83 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $30.20 | $52.48 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $199.53 Typical High $331.13 | Professional | 54 · Surgery only | $112.20 | $199.53 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $39.81 Typical High $67.61 | Professional | 55 · Aftercare only | $22.39 | $39.81 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $15.14 | $26.30 | $44.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $186.21 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $104.71 | $186.21 | $309.03 |
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
$251
AK $457KY $102
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.