How much rates vary
Facilitymedian $282 · 10th to 90th $102 to $603Professionalmedian $209 · 10th to 90th $148 to $288
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $281.84 | Professional | None | $120.23 | $218.78 | $281.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $302.00 Typical High $602.56 | Facility | None | $75.86 | $302.00 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $302.00 | Professional | None | $173.78 | $223.87 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $223.87 | Professional | None | $151.36 | $181.97 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $4,466.84 | Facility | None | $131.83 | $218.78 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $323.59 | Professional | None | $147.91 | $218.78 | $323.59 |
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 $194.98 Median $194.98 Typical High $281.84 | Facility | None | $194.98 | $194.98 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $316.23 | Professional | None | $194.98 | $281.84 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $234.42 | Professional | None | $173.78 | $213.80 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $194.98 | Facility | None | $134.90 | $138.04 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $186.21 | Professional | None | $123.03 | $134.90 | $186.21 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $269.15 | Professional | None | $117.49 | $177.83 | $269.15 |
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 $74.13 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $74.13 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $30.20 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $22.39 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $104.71 | $151.36 | $199.53 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $162.18 | $194.98 | $269.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $31.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $323.59 Typical High $380.19 | Professional | 63 · Small infant | $213.80 | $323.59 | $380.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $181.97 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $74.13 | $109.65 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $30.20 | $43.65 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $162.18 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $22.39 | $32.36 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $21.88 | $28.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $104.71 | $151.36 | $199.53 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 10th of 51
$214
AK $457KY $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.