How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,023 to $8,913Professionalmedian $912 · 10th to 90th $617 to $1,096
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $8,912.51 | Facility | None | $2,344.23 | $3,801.89 | $8,912.51 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $5,370.32 Typical High $15,135.61 | Facility | 50 · Both sides | $3,548.13 | $5,370.32 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,148.15 | Professional | None | $851.14 | $1,023.29 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,584.89 Typical High $1,819.70 | Professional | 50 · Both sides | $1,380.38 | $1,584.89 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,905.46 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $933.25 | Professional | None | $660.69 | $794.33 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,096.48 Typical High $5,495.41 | Facility | None | $537.03 | $1,096.48 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,096.48 | Professional | None | $741.31 | $1,047.13 | $1,096.48 |
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 $831.76 Median $1,023.29 Typical High $1,023.29 | Facility | None | $831.76 | $1,023.29 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,023.29 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,165.95 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | None | $851.14 | $851.14 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $501.19 Typical High $7,079.46 | Facility | None | $489.78 | $501.19 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $691.83 | Professional | None | $489.78 | $489.78 | $691.83 |
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 $549.54 Median $776.25 Typical High $1,148.15 | Professional | None | $549.54 | $776.25 | $1,148.15 |
17 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 $331.13 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $331.13 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $131.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $501.19 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $100.00 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $66.07 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $467.74 | $758.58 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $954.99 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $114.82 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $660.69 Typical High $707.95 | Professional | 62 · Two surgeons | $575.44 | $660.69 | $707.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,096.48 Median $1,258.93 Typical High $1,380.38 | Professional | 63 · Small infant | $1,096.48 | $1,258.93 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $371.54 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $147.91 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $549.54 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $109.65 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $512.86 | $758.58 | $758.58 |
Where Idaho sits
The same service costs 8.7 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· 14th of 51
$1,072
OK $3,631UT $417
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.