How much rates vary
Facilitymedian $1,380 · 10th to 90th $355 to $4,786Professionalmedian $316 · 10th to 90th $214 to $437
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 $181.97 Median $309.03 Typical High $436.52 | Professional | None | $181.97 | $309.03 | $436.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $4,786.30 | Facility | None | $1,380.38 | $1,905.46 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $478.63 | Professional | None | $263.03 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | None | $234.42 | $281.84 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $436.52 Typical High $5,495.41 | Facility | None | $141.25 | $436.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $436.52 | Professional | None | $229.09 | $338.84 | $436.52 |
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 $295.12 Median $295.12 Typical High $436.52 | Facility | None | $295.12 | $295.12 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $501.19 | Professional | None | $295.12 | $436.52 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $371.54 | Professional | None | $263.03 | $331.13 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $3,890.45 | Facility | None | $208.93 | $213.80 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $288.40 | Professional | None | $186.21 | $208.93 | $288.40 |
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 $186.21 Median $269.15 Typical High $416.87 | Professional | None | $186.21 | $269.15 | $416.87 |
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 $114.82 Median $169.82 Typical High $218.78 | Professional | 52 · Reduced service | $114.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $67.61 Typical High $89.13 | Professional | 53 · Discontinued | $45.71 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $257.04 Typical High $331.13 | Professional | 54 · Surgery only | $169.82 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $51.29 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.91 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $239.88 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $309.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $331.13 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $331.13 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $48.98 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $48.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $389.05 Typical High $588.84 | Professional | 63 · Small infant | $331.13 | $389.05 | $588.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $223.87 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $186.21 | $223.87 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $169.82 Typical High $218.78 | Professional | 52 · Reduced service | $114.82 | $169.82 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $67.61 Typical High $89.13 | Professional | 53 · Discontinued | $45.71 | $67.61 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $257.04 Typical High $331.13 | Professional | 54 · Surgery only | $169.82 | $257.04 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $51.29 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $51.29 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.91 | $33.88 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $239.88 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $309.03 |
Where Idaho sits
The same service costs 4.6 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· 13th of 51
$339
AK $912UT $200
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.