How much rates vary
Facilitymedian $479 · 10th to 90th $282 to $1,660Professionalmedian $417 · 10th to 90th $282 to $646
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 $281.84 Median $575.44 Typical High $851.14 | Professional | None | $281.84 | $575.44 | $851.14 |
BCBS Idaho Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $1,659.59 | Facility | None | $380.19 | $776.25 | $1,659.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $645.65 | Professional | None | $338.84 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $489.78 | Facility | None | $323.59 | $363.08 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $467.74 | Professional | None | $281.84 | $354.81 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $831.76 Typical High $5,495.41 | Facility | None | $204.17 | $831.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $851.14 | Professional | None | $309.03 | $537.03 | $851.14 |
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 $371.54 Median $371.54 Typical High $602.56 | Facility | None | $371.54 | $371.54 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $602.56 | Professional | None | $371.54 | $446.68 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,819.70 | Facility | None | $870.96 | $1,288.25 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $588.84 | Professional | None | $380.19 | $426.58 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $1,862.09 | Facility | None | $281.84 | $288.40 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $371.54 | Professional | None | $234.42 | $281.84 | $371.54 |
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 $229.09 Median $346.74 Typical High $588.84 | Professional | None | $229.09 | $346.74 | $588.84 |
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 $141.25 Median $288.40 Typical High $426.58 | Professional | 52 · Reduced service | $141.25 | $288.40 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $56.23 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $213.80 | $436.52 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $42.66 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $199.53 | $407.38 | $588.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $302.00 | $501.19 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $41.69 Typical High $61.66 | Professional | 55 · Aftercare only | $33.88 | $41.69 | $61.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $407.38 Median $478.63 Typical High $776.25 | Professional | 63 · Small infant | $407.38 | $478.63 | $776.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $288.40 Typical High $426.58 | Professional | 52 · Reduced service | $141.25 | $288.40 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $56.23 | $114.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $213.80 | $436.52 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $42.66 | $87.10 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $199.53 | $407.38 | $588.84 |
Where Idaho sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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
$417
WI $891UT $240
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.