How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,950 to $14,125Professionalmedian $1,950 · 10th to 90th $1,148 to $2,754
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,071.52 | $2,754.23 | $2,754.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,548.13 | $5,754.40 | $15,135.61 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $8,511.38 Typical High $22,908.68 | Facility | 50 · Both sides | $5,128.61 | $8,511.38 | $22,908.68 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,137.96 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,090.30 Typical High $3,311.31 | Professional | 50 · Both sides | $2,630.27 | $3,090.30 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,621.81 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $5,495.41 | Facility | None | $933.25 | $2,754.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,584.89 | $2,041.74 | $2,754.23 |
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 $1,584.89 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,584.89 | $1,949.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,949.84 | $1,949.84 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,290.87 | Professional | None | $1,778.28 | $2,238.72 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $10,715.19 | Facility | None | $933.25 | $954.99 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,380.38 | Professional | None | $933.25 | $933.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,479.11 | $2,238.72 |
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 $616.60 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $616.60 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $245.47 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $933.25 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $186.21 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $123.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $870.96 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,862.09 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,137.96 Median $2,511.89 Typical High $2,630.27 | Professional | 63 · Small infant | $2,137.96 | $2,511.89 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,445.44 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,445.44 | $1,548.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $794.33 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $316.23 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,202.26 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $239.88 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $158.49 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,905.46 | $1,905.46 |
Where Idaho sits
The same service costs 3.4 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $11,546MT $3,360
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.