How much rates vary
Facilitymedian $1,445 · 10th to 90th $759 to $6,026Professionalmedian $631 · 10th to 90th $427 to $1,047
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 $426.58 Median $1,047.13 Typical High $1,047.13 | Professional | None | $426.58 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $316.23 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $63.10 | $158.49 | $158.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $2,691.53 Typical High $6,025.60 | Facility | None | $1,202.26 | $2,691.53 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $707.95 | Professional | None | $562.34 | $676.08 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $69.18 |
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 $436.52 Median $512.86 Typical High $602.56 | Professional | None | $436.52 | $512.86 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,047.13 Typical High $5,495.41 | Facility | None | $457.09 | $1,047.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,047.13 | Professional | None | $478.63 | $676.08 | $1,047.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $363.08 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $72.44 | $158.49 | $158.49 |
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 $501.19 Median $616.60 Typical High $616.60 | Facility | None | $501.19 | $616.60 | $616.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $7,413.10 | Facility | None | $3,630.78 | $5,754.40 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | None | $602.56 | $707.95 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $6,025.60 | Facility | None | $295.12 | $302.00 | $6,025.60 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $676.08 | Professional | None | $295.12 | $295.12 | $676.08 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $831.76 | Professional | None | $389.05 | $512.86 | $831.76 |
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 $213.80 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $213.80 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $85.11 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $42.66 | $104.71 | $104.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $794.33 Typical High $831.76 | Professional | 63 · Small infant | $676.08 | $794.33 | $831.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $239.88 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $95.50 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $47.86 | $104.71 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 22 · Increased work | $933.25 | $933.25 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 63 · Small infant | $933.25 | $933.25 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Where Idaho sits
The same service costs 4.8 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· 10th of 51
$661
AK $1,413UT $295
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.