How much rates vary
Facilitymedian $1,096 · 10th to 90th $468 to $4,467Professionalmedian $468 · 10th to 90th $224 to $977
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 $218.78 Median $467.74 Typical High $1,258.93 | Professional | None | $218.78 | $467.74 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $354.81 Typical High $954.99 | Professional | 54 · Surgery only | $162.18 | $354.81 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $70.79 Typical High $190.55 | Professional | 55 · Aftercare only | $32.36 | $70.79 | $190.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,202.26 Typical High $4,897.79 | Facility | None | $912.01 | $1,202.26 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $977.24 | Professional | None | $269.15 | $616.60 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $275.42 Typical High $851.14 | Professional | 54 · Surgery only | $234.42 | $275.42 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $97.72 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $97.72 |
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 $223.87 Median $338.84 Typical High $676.08 | Professional | None | $223.87 | $338.84 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $645.65 Typical High $5,495.41 | Facility | None | $181.97 | $645.65 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $1,258.93 | Professional | None | $234.42 | $467.74 | $1,258.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $354.81 Typical High $954.99 | Professional | 54 · Surgery only | $162.18 | $354.81 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $70.79 Typical High $190.55 | Professional | 55 · Aftercare only | $32.36 | $70.79 | $190.55 |
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 $281.84 Median $281.84 Typical High $912.01 | Facility | None | $281.84 | $281.84 | $912.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $912.01 | Professional | None | $281.84 | $489.78 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $575.44 | Professional | 54 · Surgery only | $218.78 | $346.74 | $575.44 |
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 $302.00 Median $398.11 Typical High $831.76 | Professional | None | $302.00 | $398.11 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $3,311.31 | Facility | None | $436.52 | $446.68 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $524.81 | Professional | None | $177.83 | $436.52 | $524.81 |
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 $173.78 Median $389.05 Typical High $724.44 | Professional | None | $173.78 | $389.05 | $724.44 |
10 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 $109.65 Median $234.42 Typical High $630.96 | Professional | 52 · Reduced service | $109.65 | $234.42 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $93.33 Typical High $251.19 | Professional | 53 · Discontinued | $43.65 | $93.33 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $46.77 Typical High $125.89 | Professional | 56 · Pre-op care only | $21.88 | $46.77 | $125.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $380.19 Typical High $1,174.90 | Professional | 63 · Small infant | $323.59 | $380.19 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $234.42 Typical High $630.96 | Professional | 52 · Reduced service | $109.65 | $234.42 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $93.33 Typical High $251.19 | Professional | 53 · Discontinued | $43.65 | $93.33 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $46.77 Typical High $125.89 | Professional | 56 · Pre-op care only | $21.88 | $46.77 | $125.89 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $81.28 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $616.60 |
Where Idaho sits
The same service costs 4.5 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· 12th of 51
$468
AK $851DC $191
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.