How much rates vary
Facilitymedian $1,862 · 10th to 90th $269 to $7,244Professionalmedian $263 · 10th to 90th $120 to $468
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $263.03 Typical High $588.84 | Professional | None | $104.71 | $263.03 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $776.25 Median $2,238.72 Typical High $8,317.64 | Facility | None | $776.25 | $2,238.72 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $354.81 Typical High $457.09 | Professional | None | $144.54 | $354.81 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,778.28 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $323.59 | Professional | None | $120.23 | $218.78 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $380.19 Typical High $5,495.41 | Facility | None | $104.71 | $380.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $588.84 | Professional | None | $131.83 | $263.03 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $416.87 | Facility | None | $158.49 | $158.49 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $389.05 Typical High $416.87 | Professional | None | $158.49 | $389.05 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $10,471.29 | Facility | None | $5,495.41 | $7,943.28 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $371.54 | Professional | None | $165.96 | $177.83 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $2,089.30 | Facility | None | $199.53 | $204.17 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $234.42 | Professional | None | $97.72 | $199.53 | $234.42 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $426.58 | Professional | None | $109.65 | $223.87 | $426.58 |
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 $52.48 Median $131.83 Typical High $295.12 | Professional | 52 · Reduced service | $52.48 | $131.83 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $53.70 Typical High $117.49 | Professional | 53 · Discontinued | $20.89 | $53.70 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $199.53 Typical High $446.68 | Professional | 54 · Surgery only | $79.43 | $199.53 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $39.81 Typical High $89.13 | Professional | 55 · Aftercare only | $15.85 | $39.81 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $26.30 Typical High $58.88 | Professional | 56 · Pre-op care only | $10.47 | $26.30 | $58.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $426.58 | Professional | 54 · Surgery only | $128.82 | $158.49 | $426.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $14.45 | $38.90 | $46.77 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $173.78 Median $213.80 Typical High $512.86 | Professional | 63 · Small infant | $173.78 | $213.80 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $131.83 Typical High $295.12 | Professional | 52 · Reduced service | $56.23 | $131.83 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $53.70 Typical High $117.49 | Professional | 53 · Discontinued | $22.39 | $53.70 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $199.53 Typical High $446.68 | Professional | 54 · Surgery only | $85.11 | $199.53 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $39.81 Typical High $89.13 | Professional | 55 · Aftercare only | $16.98 | $39.81 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $26.30 Typical High $58.88 | Professional | 56 · Pre-op care only | $11.22 | $26.30 | $58.88 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in Nebraska. 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
$339
AK $646NE $158
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.