How much rates vary
Facilitymedian $5,370 · 10th to 90th $933 to $13,804Professionalmedian $214 · 10th to 90th $135 to $331
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 $138.04 Median $331.13 Typical High $331.13 | Professional | None | $138.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $97.72 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $19.95 | $50.12 | $50.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,778.28 Median $5,888.44 Typical High $14,791.08 | Facility | None | $1,778.28 | $5,888.44 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | None | $190.55 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $199.53 | $208.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $5,495.41 Typical High $7,413.10 | Facility | None | $4,897.79 | $5,495.41 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $194.98 | Professional | None | $141.25 | $165.96 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $331.13 Typical High $5,495.41 | Facility | None | $109.65 | $331.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $331.13 | Professional | None | $158.49 | $218.78 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $117.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $23.44 | $50.12 | $50.12 |
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 $169.82 Median $208.93 Typical High $208.93 | Facility | None | $169.82 | $208.93 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | None | $208.93 | $208.93 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $13,803.84 Typical High $18,620.87 | Facility | None | $9,772.37 | $13,803.84 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $5,888.44 | Facility | None | $100.00 | $100.00 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $213.80 | Professional | None | $100.00 | $100.00 | $213.80 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $257.04 | Professional | None | $128.82 | $165.96 | $257.04 |
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 $66.07 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $66.07 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $26.30 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.18 | $33.11 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $229.09 Median $263.03 Typical High $281.84 | Professional | 63 · Small infant | $229.09 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $79.43 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $31.62 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.85 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 22 · Increased work | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 63 · Small infant | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
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· 9th of 51
$219
AK $468UT $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.