How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,096 to $7,943Professionalmedian $1,096 · 10th to 90th $468 to $2,818
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $1,348.96 Typical High $3,981.07 | Professional | None | $416.87 | $1,348.96 | $3,981.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,019.95 Median $3,981.07 Typical High $8,511.38 | Facility | None | $3,019.95 | $3,981.07 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $1,949.84 Typical High $2,570.40 | Professional | None | $537.03 | $1,949.84 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $2,398.83 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $2,238.72 | Professional | None | $457.09 | $691.83 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $1,905.46 Typical High $5,623.41 | Facility | None | $416.87 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,981.07 | Professional | None | $512.86 | $1,445.44 | $3,981.07 |
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 $588.84 Median $588.84 Typical High $2,290.87 | Facility | None | $588.84 | $588.84 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $2,290.87 Typical High $2,570.40 | Professional | None | $588.84 | $2,290.87 | $2,570.40 |
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 $630.96 Median $707.95 Typical High $2,511.89 | Professional | None | $630.96 | $707.95 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,148.15 | Facility | None | $1,096.48 | $1,096.48 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $1,096.48 Typical High $1,513.56 | Professional | None | $380.19 | $1,096.48 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,096.48 Typical High $3,019.95 | Professional | None | $407.38 | $1,096.48 | $3,019.95 |
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 $208.93 Median $501.19 Typical High $1,995.26 | Professional | 52 · Reduced service | $208.93 | $501.19 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $204.17 Typical High $794.33 | Professional | 53 · Discontinued | $83.18 | $204.17 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $758.58 Typical High $2,951.21 | Professional | 54 · Surgery only | $316.23 | $758.58 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $151.36 Typical High $588.84 | Professional | 55 · Aftercare only | $63.10 | $151.36 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $102.33 Typical High $398.11 | Professional | 56 · Pre-op care only | $41.69 | $102.33 | $398.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $2,290.87 | Professional | 54 · Surgery only | $467.74 | $588.84 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $257.04 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $257.04 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $758.58 Typical High $3,090.30 | Professional | 63 · Small infant | $645.65 | $758.58 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $1,479.11 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $380.19 | $1,479.11 | $1,819.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $501.19 Typical High $1,995.26 | Professional | 52 · Reduced service | $218.78 | $501.19 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $204.17 Typical High $794.33 | Professional | 53 · Discontinued | $87.10 | $204.17 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $758.58 Typical High $2,951.21 | Professional | 54 · Surgery only | $323.59 | $758.58 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $151.36 Typical High $588.84 | Professional | 55 · Aftercare only | $64.57 | $151.36 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $102.33 Typical High $398.11 | Professional | 56 · Pre-op care only | $43.65 | $102.33 | $398.11 |
Where Idaho sits
The same service costs 5.1 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· 7th of 51
$2,042
AK $3,020NE $589
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.