How much rates vary
Facilitymedian $891 · 10th to 90th $380 to $3,090Professionalmedian $309 · 10th to 90th $155 to $501
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 $147.91 Median $323.59 Typical High $645.65 | Professional | None | $147.91 | $323.59 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $239.88 Typical High $489.78 | Professional | 54 · Surgery only | $112.20 | $239.88 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $47.86 Typical High $97.72 | Professional | 55 · Aftercare only | $22.39 | $47.86 | $97.72 |
BCBS Idaho Setting Facility Modifier None Typical Low $776.25 Median $1,380.38 Typical High $3,090.30 | Facility | None | $776.25 | $1,380.38 | $3,090.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $501.19 | Professional | None | $190.55 | $331.13 | $501.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $446.68 | Professional | 54 · Surgery only | $186.21 | $199.53 | $446.68 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.38 Typical High $50.12 | Professional | 55 · Aftercare only | $19.05 | $21.38 | $50.12 |
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 $154.88 Median $218.78 Typical High $346.74 | Professional | None | $154.88 | $218.78 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $389.05 Typical High $5,495.41 | Facility | None | $97.72 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $645.65 | Professional | None | $169.82 | $323.59 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $239.88 Typical High $489.78 | Professional | 54 · Surgery only | $112.20 | $239.88 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $47.86 Typical High $97.72 | Professional | 55 · Aftercare only | $22.39 | $47.86 | $97.72 |
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 $199.53 Median $199.53 Typical High $467.74 | Facility | None | $199.53 | $199.53 | $467.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $467.74 | Professional | None | $199.53 | $338.84 | $467.74 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $151.36 | $239.88 | $302.00 |
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 $208.93 Median $269.15 Typical High $446.68 | Professional | None | $208.93 | $269.15 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $2,041.74 | Facility | None | $223.87 | $223.87 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $275.42 | Professional | None | $125.89 | $223.87 | $275.42 |
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 $123.03 Median $218.78 Typical High $407.38 | Professional | None | $123.03 | $218.78 | $407.38 |
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 $74.13 Median $162.18 Typical High $323.59 | Professional | 52 · Reduced service | $74.13 | $162.18 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $64.57 Typical High $131.83 | Professional | 53 · Discontinued | $30.20 | $64.57 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $32.36 Typical High $64.57 | Professional | 56 · Pre-op care only | $14.79 | $32.36 | $64.57 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $512.86 Typical High $602.56 | Professional | 63 · Small infant | $218.78 | $512.86 | $602.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $154.88 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $128.82 | $154.88 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $162.18 Typical High $323.59 | Professional | 52 · Reduced service | $74.13 | $162.18 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $64.57 Typical High $131.83 | Professional | 53 · Discontinued | $30.20 | $64.57 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $32.36 Typical High $64.57 | Professional | 56 · Pre-op care only | $14.79 | $32.36 | $64.57 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $21.38 | $33.88 | $42.66 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $257.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $162.18 | $257.04 | $323.59 |
Where Idaho sits
The same service costs 3.8 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· 6th of 51
$316
AK $490DC $129
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.