How much rates vary
Facilitymedian $1,413 · 10th to 90th $427 to $5,248Professionalmedian $347 · 10th to 90th $245 to $490
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 $239.88 Median $426.58 Typical High $512.86 | Professional | None | $239.88 | $426.58 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,348.96 | $2,454.71 | $5,248.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $489.78 | Professional | None | $288.40 | $363.08 | $489.78 |
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 $257.04 Median $295.12 Typical High $363.08 | Professional | None | $257.04 | $295.12 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $512.86 Typical High $5,495.41 | Facility | None | $177.83 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $512.86 | Professional | None | $245.47 | $380.19 | $512.86 |
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 $331.13 Median $331.13 Typical High $446.68 | Facility | None | $331.13 | $331.13 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $512.86 | Professional | None | $331.13 | $446.68 | $512.86 |
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 $288.40 Median $354.81 Typical High $380.19 | Professional | None | $288.40 | $354.81 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $4,073.80 | Facility | None | $213.80 | $218.78 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $295.12 | Professional | None | $208.93 | $213.80 | $295.12 |
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 $204.17 Median $295.12 Typical High $426.58 | Professional | None | $204.17 | $295.12 | $426.58 |
16 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 $120.23 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $120.23 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $48.98 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $181.97 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $36.31 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $24.55 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $169.82 | $295.12 | $363.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $457.09 | Professional | 54 · Surgery only | $281.84 | $371.54 | $457.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $50.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $371.54 Median $489.78 Typical High $602.56 | Professional | 63 · Small infant | $371.54 | $489.78 | $602.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $213.80 | $263.03 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $120.23 | $213.80 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $48.98 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $181.97 | $316.23 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $36.31 | $64.57 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $24.55 | $42.66 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $169.82 | $295.12 | $363.08 |
Where Idaho sits
The same service costs 5.6 times more in Oklahoma 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· 13th of 51
$372
OK $1,148UT $204
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.