How much rates vary
Facilitymedian $1,047 · 10th to 90th $141 to $7,079Professionalmedian $204 · 10th to 90th $132 to $316
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 $239.88 Median $1,412.54 Typical High $7,079.46 | Facility | None | $239.88 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $295.12 | Professional | None | $112.20 | $199.53 | $295.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $158.49 Median $1,698.24 Typical High $8,128.31 | Facility | None | $158.49 | $1,698.24 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $338.84 | Professional | None | $177.83 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $190.55 | Facility | None | $125.89 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $245.47 | Professional | None | $141.25 | $181.97 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $281.84 Typical High $5,495.41 | Facility | None | $128.82 | $281.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $323.59 | Professional | None | $138.04 | $208.93 | $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 $204.17 Median $204.17 Typical High $316.23 | Facility | None | $204.17 | $204.17 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $346.74 | Professional | None | $204.17 | $316.23 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,244.36 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $275.42 | Professional | None | $177.83 | $223.87 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $4,265.80 | Facility | None | $151.36 | $151.36 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $208.93 | Professional | None | $131.83 | $151.36 | $208.93 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $229.09 | Professional | None | $114.82 | $154.88 | $229.09 |
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 $67.61 Median $100.00 Typical High $144.54 | Professional | 52 · Reduced service | $67.61 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $58.88 | Professional | 53 · Discontinued | $27.54 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $147.91 Typical High $218.78 | Professional | 54 · Surgery only | $102.33 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $138.04 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $95.50 | $138.04 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $199.53 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $199.53 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $25.70 | $35.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $275.42 Typical High $407.38 | Professional | 63 · Small infant | $218.78 | $275.42 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $100.00 Typical High $144.54 | Professional | 52 · Reduced service | $67.61 | $100.00 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $58.88 | Professional | 53 · Discontinued | $27.54 | $39.81 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $147.91 Typical High $218.78 | Professional | 54 · Surgery only | $102.33 | $147.91 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $138.04 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $95.50 | $138.04 | $204.17 |
Where Idaho sits
The same service costs 3.7 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· 11th of 51
$214
AK $468KY $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.