How much rates vary
Facilitymedian $891 · 10th to 90th $437 to $3,548Professionalmedian $407 · 10th to 90th $269 to $676
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 $269.15 Median $676.08 Typical High $676.08 | Professional | None | $269.15 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $199.53 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $40.74 | $100.00 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $3,548.13 | Facility | None | $891.25 | $891.25 | $3,548.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $446.68 | Professional | None | $371.54 | $436.52 | $446.68 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $44.67 |
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 $288.40 Median $331.13 Typical High $389.05 | Professional | None | $288.40 | $331.13 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $676.08 Typical High $5,495.41 | Facility | None | $190.55 | $676.08 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $676.08 | Professional | None | $309.03 | $436.52 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $234.42 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $46.77 | $100.00 | $100.00 |
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 $323.59 Median $398.11 Typical High $398.11 | Facility | None | $323.59 | $398.11 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | None | $398.11 | $398.11 | $446.68 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $309.03 | $309.03 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,890.45 | Facility | None | $1,995.26 | $2,630.27 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $457.09 | Professional | None | $380.19 | $446.68 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $426.58 | Professional | None | $190.55 | $190.55 | $426.58 |
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 $251.19 Median $316.23 Typical High $489.78 | Professional | None | $251.19 | $316.23 | $489.78 |
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 $134.90 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $134.90 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $53.70 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $26.92 | $67.61 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $512.86 Typical High $537.03 | Professional | 63 · Small infant | $446.68 | $512.86 | $537.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $154.88 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $61.66 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $30.90 | $67.61 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 22 · Increased work | $489.78 | $489.78 | $489.78 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 63 · Small infant | $489.78 | $489.78 | $489.78 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $331.13 |
Where Idaho sits
The same service costs 4.7 times more in Wyoming 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· 11th of 51
$427
WY $912UT $195
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.