How much rates vary
Facilitymedian $631 · 10th to 90th $209 to $7,079Professionalmedian $295 · 10th to 90th $178 to $479
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 $141.25 Median $380.19 Typical High $676.08 | Professional | None | $141.25 | $380.19 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $281.84 Typical High $501.19 | Professional | 54 · Surgery only | $138.04 | $281.84 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $56.23 Typical High $100.00 | Professional | 55 · Aftercare only | $27.54 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $263.03 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $128.82 | $263.03 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $1,348.96 Typical High $8,317.64 | Facility | None | $229.09 | $1,348.96 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $478.63 | Professional | None | $223.87 | $302.00 | $478.63 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $190.55 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $47.86 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $47.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $177.83 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $147.91 | $177.83 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $281.84 | Facility | None | $186.21 | $208.93 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $363.08 | Professional | None | $177.83 | $239.88 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $537.03 Typical High $5,495.41 | Facility | None | $125.89 | $537.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $676.08 | Professional | None | $181.97 | $380.19 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $281.84 Typical High $501.19 | Professional | 54 · Surgery only | $138.04 | $281.84 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $56.23 Typical High $100.00 | Professional | 55 · Aftercare only | $27.54 | $56.23 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $263.03 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $128.82 | $263.03 | $467.74 |
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 $229.09 Median $229.09 Typical High $436.52 | Facility | None | $229.09 | $229.09 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $446.68 | Professional | None | $229.09 | $263.03 | $446.68 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $316.23 | Professional | 54 · Surgery only | $177.83 | $177.83 | $316.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $457.09 | Professional | None | $251.19 | $302.00 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $3,981.07 | Facility | None | $208.93 | $213.80 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $288.40 | Professional | None | $147.91 | $208.93 | $288.40 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $398.11 | Professional | None | $141.25 | $239.88 | $398.11 |
8 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 $91.20 Median $190.55 Typical High $338.84 | Professional | 52 · Reduced service | $91.20 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $75.86 Typical High $134.90 | Professional | 53 · Discontinued | $36.31 | $75.86 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $38.02 Typical High $67.61 | Professional | 56 · Pre-op care only | $18.20 | $38.02 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $263.03 Median $478.63 Typical High $562.34 | Professional | 63 · Small infant | $263.03 | $478.63 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $190.55 Typical High $338.84 | Professional | 52 · Reduced service | $91.20 | $190.55 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $75.86 Typical High $134.90 | Professional | 53 · Discontinued | $36.31 | $75.86 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $38.02 Typical High $67.61 | Professional | 56 · Pre-op care only | $18.20 | $38.02 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $44.67 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 8th of 51
$309
AK $525DC $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.