How much rates vary
Facilitymedian $1,738 · 10th to 90th $347 to $6,166Professionalmedian $240 · 10th to 90th $115 to $468
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 $114.82 Median $239.88 Typical High $602.56 | Professional | None | $114.82 | $239.88 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $181.97 Typical High $446.68 | Professional | 54 · Surgery only | $85.11 | $181.97 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $36.31 Typical High $91.20 | Professional | 55 · Aftercare only | $16.98 | $36.31 | $91.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $724.44 Median $1,949.84 Typical High $7,244.36 | Facility | None | $724.44 | $1,949.84 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $467.74 | Professional | None | $147.91 | $295.12 | $467.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $407.38 | Professional | 54 · Surgery only | $141.25 | $154.88 | $407.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $16.22 | $39.81 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,398.83 | Facility | None | $1,584.89 | $1,778.28 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $323.59 | Professional | None | $114.82 | $177.83 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $346.74 Typical High $5,495.41 | Facility | None | $72.44 | $346.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $602.56 | Professional | None | $134.90 | $239.88 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $181.97 Typical High $446.68 | Professional | 54 · Surgery only | $85.11 | $181.97 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $36.31 Typical High $91.20 | Professional | 55 · Aftercare only | $16.98 | $36.31 | $91.20 |
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 $154.88 Median $154.88 Typical High $436.52 | Facility | None | $154.88 | $154.88 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $436.52 | Professional | None | $154.88 | $257.04 | $436.52 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $177.83 Typical High $275.42 | Professional | 54 · Surgery only | $112.20 | $177.83 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $6,309.57 Typical High $9,120.11 | Facility | None | $4,073.80 | $6,309.57 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $407.38 | Professional | None | $158.49 | $213.80 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $2,754.23 | Facility | None | $208.93 | $208.93 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $251.19 | Professional | None | $100.00 | $208.93 | $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 $93.33 Median $186.21 Typical High $354.81 | Professional | None | $93.33 | $186.21 | $354.81 |
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 $57.54 Median $120.23 Typical High $302.00 | Professional | 52 · Reduced service | $57.54 | $120.23 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $47.86 Typical High $120.23 | Professional | 53 · Discontinued | $22.91 | $47.86 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $23.99 Typical High $60.26 | Professional | 56 · Pre-op care only | $11.48 | $23.99 | $60.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $173.78 Median $467.74 Typical High $562.34 | Professional | 63 · Small infant | $173.78 | $467.74 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $120.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $100.00 | $120.23 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $120.23 Typical High $302.00 | Professional | 52 · Reduced service | $57.54 | $120.23 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $47.86 Typical High $120.23 | Professional | 53 · Discontinued | $22.91 | $47.86 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $23.99 Typical High $60.26 | Professional | 56 · Pre-op care only | $11.48 | $23.99 | $60.26 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.70 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.22 | $25.70 | $38.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $190.55 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $120.23 | $190.55 | $295.12 |
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· 10th of 51
$240
AK $437DC $97.72
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.