How much rates vary
Facilitymedian $229 · 10th to 90th $132 to $525Professionalmedian $209 · 10th to 90th $129 to $355
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 $229.09 Median $389.05 Typical High $5,495.41 | Facility | None | $229.09 | $389.05 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $323.59 | Professional | None | $112.20 | $194.98 | $323.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $512.86 | Facility | None | $117.49 | $194.98 | $512.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $380.19 | Professional | None | $169.82 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $138.04 Typical High $186.21 | Facility | None | $123.03 | $138.04 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $275.42 | Professional | None | $151.36 | $186.21 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $1,412.54 | Facility | None | $162.18 | $323.59 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $363.08 | Professional | None | $131.83 | $218.78 | $363.08 |
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 $354.81 | Facility | None | $194.98 | $194.98 | $354.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $354.81 | Professional | None | $194.98 | $316.23 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $645.65 | Facility | None | $331.13 | $467.74 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $309.03 | Professional | None | $169.82 | $213.80 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $169.82 Typical High $346.74 | Facility | None | $165.96 | $169.82 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $234.42 | Professional | None | $123.03 | $165.96 | $234.42 |
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 $112.20 Median $169.82 Typical High $245.47 | Professional | None | $112.20 | $169.82 | $245.47 |
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 $66.07 Median $95.50 Typical High $162.18 | Professional | 52 · Reduced service | $66.07 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.90 Typical High $64.57 | Professional | 53 · Discontinued | $26.30 | $38.90 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $144.54 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $48.98 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $32.36 | Professional | 56 · Pre-op care only | $13.18 | $19.50 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $229.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $181.97 | $295.12 | $346.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $37.15 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $37.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $380.19 Typical High $467.74 | Professional | 63 · Small infant | $213.80 | $380.19 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $95.50 Typical High $162.18 | Professional | 52 · Reduced service | $66.07 | $95.50 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.90 Typical High $64.57 | Professional | 53 · Discontinued | $26.30 | $38.90 | $64.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $158.49 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $158.49 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $48.98 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $32.36 | Professional | 56 · Pre-op care only | $13.18 | $19.50 | $32.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $229.09 |
Where Idaho sits
The same service costs 3.6 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· 15th of 51
$209
AK $457KY $126
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.