How much rates vary
Facilitymedian $347 · 10th to 90th $151 to $1,072Professionalmedian $251 · 10th to 90th $162 to $407
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 $346.74 Median $575.44 Typical High $5,495.41 | Facility | None | $346.74 | $575.44 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $478.63 | Professional | None | $144.54 | $281.84 | $478.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $169.82 Median $512.86 Typical High $1,071.52 | Facility | None | $169.82 | $512.86 | $1,071.52 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $407.38 | Professional | None | $186.21 | $323.59 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $213.80 | Facility | None | $138.04 | $154.88 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $309.03 | Professional | None | $162.18 | $218.78 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $416.87 Typical High $4,466.84 | Facility | None | $165.96 | $416.87 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $478.63 | Professional | None | $162.18 | $288.40 | $478.63 |
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 $204.17 Median $204.17 Typical High $380.19 | Facility | None | $204.17 | $204.17 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $380.19 | Professional | None | $204.17 | $239.88 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,348.96 | Facility | None | $724.44 | $1,047.13 | $1,348.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $398.11 | Professional | None | $229.09 | $251.19 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $812.83 | Facility | None | $181.97 | $186.21 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | None | $128.82 | $181.97 | $251.19 |
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 $131.83 Median $229.09 Typical High $389.05 | Professional | None | $131.83 | $229.09 | $389.05 |
14 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 $79.43 Median $144.54 Typical High $239.88 | Professional | 52 · Reduced service | $79.43 | $144.54 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $57.54 Typical High $95.50 | Professional | 53 · Discontinued | $32.36 | $57.54 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $218.78 Typical High $363.08 | Professional | 54 · Surgery only | $120.23 | $218.78 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $43.65 Typical High $72.44 | Professional | 55 · Aftercare only | $23.99 | $43.65 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $28.84 Typical High $47.86 | Professional | 56 · Pre-op care only | $15.85 | $28.84 | $47.86 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $204.17 Typical High $354.81 | Professional | 54 · Surgery only | $169.82 | $204.17 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.91 Typical High $40.74 | Professional | 55 · Aftercare only | $19.50 | $22.91 | $40.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $269.15 Typical High $512.86 | Professional | 63 · Small infant | $223.87 | $269.15 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $144.54 Typical High $239.88 | Professional | 52 · Reduced service | $79.43 | $144.54 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $57.54 Typical High $95.50 | Professional | 53 · Discontinued | $32.36 | $57.54 | $95.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $218.78 Typical High $363.08 | Professional | 54 · Surgery only | $120.23 | $218.78 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $43.65 Typical High $72.44 | Professional | 55 · Aftercare only | $23.99 | $43.65 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $28.84 Typical High $47.86 | Professional | 56 · Pre-op care only | $15.85 | $28.84 | $47.86 |
Where Idaho sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 14th of 51
$269
WI $537MD $182
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.