How much rates vary
Facilitymedian $1,778 · 10th to 90th $269 to $6,310Professionalmedian $240 · 10th to 90th $126 to $407
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 $125.89 Median $269.15 Typical High $537.03 | Professional | None | $125.89 | $269.15 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $199.53 Typical High $398.11 | Professional | 54 · Surgery only | $93.33 | $199.53 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $39.81 Typical High $81.28 | Professional | 55 · Aftercare only | $18.62 | $39.81 | $81.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,659.59 Median $3,235.94 Typical High $7,244.36 | Facility | None | $1,659.59 | $3,235.94 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $407.38 | Professional | None | $154.88 | $269.15 | $407.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $346.74 | Professional | 54 · Surgery only | $134.90 | $158.49 | $346.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.20 Typical High $39.81 | Professional | 55 · Aftercare only | $15.49 | $18.20 | $39.81 |
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 $125.89 Median $173.78 Typical High $281.84 | Professional | None | $125.89 | $173.78 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $380.19 Typical High $5,495.41 | Facility | None | $173.78 | $380.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $537.03 | Professional | None | $138.04 | $269.15 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $199.53 Typical High $398.11 | Professional | 54 · Surgery only | $93.33 | $199.53 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $39.81 Typical High $81.28 | Professional | 55 · Aftercare only | $18.62 | $39.81 | $81.28 |
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 $162.18 Median $162.18 Typical High $371.54 | Facility | None | $162.18 | $162.18 | $371.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $371.54 | Professional | None | $162.18 | $281.84 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $123.03 | $194.98 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,265.80 Median $6,309.57 Typical High $9,120.11 | Facility | None | $4,265.80 | $6,309.57 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $354.81 | Professional | None | $173.78 | $213.80 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $5,011.87 | Facility | None | $177.83 | $181.97 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $218.78 | Professional | None | $102.33 | $177.83 | $218.78 |
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 $100.00 Median $173.78 Typical High $281.84 | Professional | None | $100.00 | $173.78 | $281.84 |
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 $61.66 Median $134.90 Typical High $269.15 | Professional | 52 · Reduced service | $61.66 | $134.90 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $53.70 Typical High $107.15 | Professional | 53 · Discontinued | $25.12 | $53.70 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $26.92 Typical High $53.70 | Professional | 56 · Pre-op care only | $12.59 | $26.92 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $186.21 Median $338.84 Typical High $489.78 | Professional | 63 · Small infant | $186.21 | $338.84 | $489.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $123.03 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $104.71 | $123.03 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $134.90 Typical High $269.15 | Professional | 52 · Reduced service | $61.66 | $134.90 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $53.70 Typical High $107.15 | Professional | 53 · Discontinued | $25.12 | $53.70 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $26.92 Typical High $53.70 | Professional | 56 · Pre-op care only | $12.59 | $26.92 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $17.78 | $28.18 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $131.83 | $208.93 | $257.04 |
Where Idaho sits
The same service costs 3.6 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· 7th of 51
$251
AK $407DC $112
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.