How much rates vary
Facilitymedian $912 · 10th to 90th $437 to $4,571Professionalmedian $457 · 10th to 90th $309 to $661
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 $239.88 Median $660.69 Typical High $891.25 | Professional | None | $239.88 | $660.69 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $234.42 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $46.77 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $467.74 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $218.78 | $467.74 | $616.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $2,344.23 Typical High $4,570.88 | Facility | None | $912.01 | $2,344.23 | $4,570.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $645.65 | Professional | None | $389.05 | $457.09 | $645.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $549.54 | Professional | 54 · Surgery only | $363.08 | $398.11 | $549.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $64.57 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $64.57 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $309.03 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $257.04 | $309.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $478.63 | Professional | None | $295.12 | $371.54 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $870.96 Typical High $5,495.41 | Facility | None | $263.03 | $870.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $891.25 | Professional | None | $309.03 | $588.84 | $891.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $234.42 | $501.19 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $46.77 | $100.00 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $467.74 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $218.78 | $467.74 | $616.60 |
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 $389.05 Median $389.05 Typical High $602.56 | Facility | None | $389.05 | $389.05 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $602.56 | Professional | None | $389.05 | $446.68 | $602.56 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $316.23 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,890.45 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $616.60 | Professional | None | $436.52 | $478.63 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $4,677.35 | Facility | None | $281.84 | $288.40 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $436.52 | Professional | None | $251.19 | $281.84 | $436.52 |
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 $245.47 Median $346.74 Typical High $575.44 | Professional | None | $245.47 | $346.74 | $575.44 |
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 $154.88 Median $331.13 Typical High $446.68 | Professional | 52 · Reduced service | $154.88 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $131.83 Typical High $177.83 | Professional | 53 · Discontinued | $63.10 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $30.90 | $66.07 | $89.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $512.86 Typical High $724.44 | Professional | 63 · Small infant | $446.68 | $512.86 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $331.13 Typical High $446.68 | Professional | 52 · Reduced service | $154.88 | $331.13 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $131.83 Typical High $177.83 | Professional | 53 · Discontinued | $63.10 | $131.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $30.90 | $66.07 | $89.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $60.26 |
Where Idaho sits
The same service costs 4.3 times more in Alaska 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· 9th of 51
$457
AK $933UT $219
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.