How much rates vary
Facilitymedian $759 · 10th to 90th $288 to $4,169Professionalmedian $302 · 10th to 90th $145 to $537
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $331.13 Typical High $707.95 | Professional | None | $138.04 | $331.13 | $707.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $354.81 Median $891.25 Typical High $4,168.69 | Facility | None | $354.81 | $891.25 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $537.03 | Professional | None | $169.82 | $426.58 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $794.33 Typical High $1,096.48 | Facility | None | $707.95 | $794.33 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $398.11 | Professional | None | $151.36 | $239.88 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $467.74 Typical High $5,495.41 | Facility | None | $138.04 | $467.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $331.13 Typical High $707.95 | Professional | None | $162.18 | $331.13 | $707.95 |
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 $186.21 Median $186.21 Typical High $489.78 | Facility | None | $186.21 | $186.21 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $501.19 | Professional | None | $186.21 | $467.74 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $467.74 | Professional | None | $204.17 | $234.42 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $478.63 | Facility | None | $234.42 | $239.88 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $288.40 | Professional | None | $120.23 | $234.42 | $288.40 |
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 $123.03 Median $218.78 Typical High $389.05 | Professional | None | $123.03 | $218.78 | $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 $69.18 Median $162.18 Typical High $354.81 | Professional | 52 · Reduced service | $69.18 | $162.18 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $66.07 Typical High $141.25 | Professional | 53 · Discontinued | $27.54 | $66.07 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $245.47 Typical High $524.81 | Professional | 54 · Surgery only | $102.33 | $245.47 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $48.98 Typical High $104.71 | Professional | 55 · Aftercare only | $20.89 | $48.98 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $33.11 Typical High $70.79 | Professional | 56 · Pre-op care only | $13.80 | $33.11 | $70.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $407.38 Typical High $501.19 | Professional | 54 · Surgery only | $169.82 | $407.38 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.88 Typical High $53.70 | Professional | 55 · Aftercare only | $16.60 | $21.88 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $208.93 Median $537.03 Typical High $645.65 | Professional | 63 · Small infant | $208.93 | $537.03 | $645.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $120.23 | $316.23 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $162.18 Typical High $354.81 | Professional | 52 · Reduced service | $70.79 | $162.18 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $66.07 Typical High $141.25 | Professional | 53 · Discontinued | $28.84 | $66.07 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $245.47 Typical High $524.81 | Professional | 54 · Surgery only | $107.15 | $245.47 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $48.98 Typical High $104.71 | Professional | 55 · Aftercare only | $21.38 | $48.98 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $33.11 Typical High $70.79 | Professional | 56 · Pre-op care only | $14.45 | $33.11 | $70.79 |
Where Idaho sits
The same service costs 4.3 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· 12th of 51
$380
AK $776KY $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.