How much rates vary
Facilitymedian $1,202 · 10th to 90th $437 to $4,898Professionalmedian $245 · 10th to 90th $166 to $398
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 $181.97 Median $398.11 Typical High $398.11 | Professional | None | $181.97 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $138.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $27.54 | $58.88 | $58.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $645.65 Median $1,318.26 Typical High $4,897.79 | Facility | None | $645.65 | $1,318.26 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $269.15 | Professional | None | $218.78 | $257.04 | $269.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $229.09 | $239.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $26.92 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,513.56 | Facility | None | $977.24 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $398.11 Typical High $5,495.41 | Facility | None | $181.97 | $398.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $398.11 | Professional | None | $181.97 | $257.04 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $138.04 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $27.54 | $58.88 | $58.88 |
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 $194.98 Median $239.88 Typical High $239.88 | Facility | None | $194.98 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | None | $239.88 | $239.88 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $181.97 | $181.97 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $4,265.80 Typical High $6,165.95 | Facility | None | $2,754.23 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $263.03 | Professional | None | $223.87 | $263.03 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $114.82 Typical High $2,238.72 | Facility | None | $112.20 | $114.82 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $251.19 | Professional | None | $112.20 | $112.20 | $251.19 |
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 $147.91 Median $213.80 Typical High $398.11 | Professional | None | $147.91 | $213.80 | $398.11 |
12 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 $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $91.20 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $37.15 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.62 | $39.81 | $39.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $263.03 Median $302.00 Typical High $316.23 | Professional | 63 · Small infant | $263.03 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $91.20 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $37.15 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.62 | $39.81 | $39.81 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 22 · Increased work | $288.40 | $288.40 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 63 · Small infant | $288.40 | $288.40 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $194.98 |
Where Idaho sits
The same service costs 5.4 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· 14th of 51
$257
AK $537UT $100
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.