How much rates vary
Facilitymedian $2,344 · 10th to 90th $933 to $8,710Professionalmedian $537 · 10th to 90th $355 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 $2,884.03 Median $5,128.61 Typical High $7,762.47 | Facility | None | $2,884.03 | $5,128.61 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Professional | None | $346.74 | $467.74 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $9,120.11 | Facility | None | $1,698.24 | $2,818.38 | $9,120.11 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,511.89 Median $3,981.07 Typical High $13,489.63 | Facility | 50 · Both sides | $2,511.89 | $3,981.07 | $13,489.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $741.31 | Professional | None | $501.19 | $616.60 | $741.31 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $954.99 Typical High $1,122.02 | Professional | 50 · Both sides | $812.83 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $562.34 | Professional | None | $416.87 | $478.63 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $933.25 Typical High $7,079.46 | Facility | None | $371.54 | $933.25 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $660.69 | Professional | None | $371.54 | $616.60 | $660.69 |
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 $489.78 Median $588.84 Typical High $588.84 | Facility | None | $489.78 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,000.00 | Professional | None | $588.84 | $588.84 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | None | $501.19 | $501.19 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $3,981.07 | Facility | None | $281.84 | $288.40 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $426.58 | Professional | None | $281.84 | $281.84 | $426.58 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $676.08 | Professional | None | $331.13 | $478.63 | $676.08 |
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 $194.98 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $194.98 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $77.62 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $288.40 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $57.54 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $38.90 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $269.15 | $457.09 | $457.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $478.63 | $562.34 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $758.58 Typical High $794.33 | Professional | 63 · Small infant | $645.65 | $758.58 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $218.78 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $87.10 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $323.59 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $66.07 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $43.65 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $302.00 | $457.09 | $457.09 |
Where Idaho sits
The same service costs 5.3 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $5,518MT $1,050
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.