How much rates vary
Facilitymedian $1,380 · 10th to 90th $407 to $5,012Professionalmedian $339 · 10th to 90th $195 to $661
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 $407.38 Median $891.25 Typical High $5,495.41 | Facility | None | $407.38 | $891.25 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $741.31 | Professional | None | $173.78 | $338.84 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $5,248.07 | Facility | None | $1,318.26 | $1,949.84 | $5,248.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $676.08 | Professional | None | $229.09 | $489.78 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,659.59 | Facility | None | $1,096.48 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $524.81 | Professional | None | $213.80 | $323.59 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $741.31 Typical High $4,466.84 | Facility | None | $288.40 | $741.31 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $741.31 | Professional | None | $194.98 | $354.81 | $741.31 |
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 $269.15 Median $602.56 Typical High $1,949.84 | Facility | None | $269.15 | $602.56 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $645.65 | Professional | None | $269.15 | $457.09 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $6,606.93 | Facility | None | $3,467.37 | $5,011.87 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $537.03 | Professional | None | $229.09 | $302.00 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $4,073.80 | Facility | None | $288.40 | $295.12 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $389.05 | Professional | None | $169.82 | $288.40 | $389.05 |
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 $165.96 Median $323.59 Typical High $537.03 | Professional | None | $165.96 | $323.59 | $537.03 |
14 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 $95.50 Median $169.82 Typical High $371.54 | Professional | 52 · Reduced service | $95.50 | $169.82 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $69.18 Typical High $147.91 | Professional | 53 · Discontinued | $38.90 | $69.18 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $257.04 Typical High $562.34 | Professional | 54 · Surgery only | $144.54 | $257.04 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $51.29 Typical High $112.20 | Professional | 55 · Aftercare only | $28.84 | $51.29 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $19.50 | $33.88 | $74.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $269.15 Typical High $588.84 | Professional | 54 · Surgery only | $223.87 | $269.15 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $53.70 Typical High $67.61 | Professional | 55 · Aftercare only | $24.55 | $53.70 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $295.12 Median $346.74 Typical High $794.33 | Professional | 63 · Small infant | $295.12 | $346.74 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $173.78 | $398.11 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $169.82 Typical High $371.54 | Professional | 52 · Reduced service | $95.50 | $169.82 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $69.18 Typical High $147.91 | Professional | 53 · Discontinued | $38.90 | $69.18 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $257.04 Typical High $562.34 | Professional | 54 · Surgery only | $144.54 | $257.04 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $51.29 Typical High $112.20 | Professional | 55 · Aftercare only | $28.84 | $51.29 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $19.50 | $33.88 | $74.13 |
Where Idaho sits
The same service costs 3.0 times more in Wisconsin 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· 8th of 51
$468
WI $851UT $288
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.