How much rates vary
Facilitymedian $2,188 · 10th to 90th $380 to $7,079Professionalmedian $324 · 10th to 90th $219 to $468
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 $194.98 Median $323.59 Typical High $436.52 | Professional | None | $194.98 | $323.59 | $436.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $8,128.31 | Facility | None | $2,187.76 | $2,570.40 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $512.86 | Professional | None | $288.40 | $380.19 | $512.86 |
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 $229.09 Median $302.00 Typical High $380.19 | Professional | None | $229.09 | $302.00 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $436.52 Typical High $5,495.41 | Facility | None | $194.98 | $436.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $478.63 | Professional | None | $218.78 | $323.59 | $478.63 |
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 $323.59 Median $323.59 Typical High $467.74 | Facility | None | $323.59 | $323.59 | $467.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $549.54 | Professional | None | $323.59 | $467.74 | $549.54 |
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 $288.40 Median $354.81 Typical High $407.38 | Professional | None | $288.40 | $354.81 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $5,128.61 | Facility | None | $223.87 | $229.09 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $309.03 | Professional | None | $204.17 | $223.87 | $309.03 |
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 $190.55 Median $263.03 Typical High $389.05 | Professional | None | $190.55 | $263.03 | $389.05 |
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 $109.65 Median $162.18 Typical High $213.80 | Professional | 52 · Reduced service | $109.65 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $64.57 Typical High $87.10 | Professional | 53 · Discontinued | $43.65 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $302.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $467.74 | Professional | 54 · Surgery only | $269.15 | $316.23 | $467.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $35.48 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $35.48 | $47.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $512.86 Typical High $630.96 | Professional | 63 · Small infant | $363.08 | $512.86 | $630.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $162.18 Typical High $213.80 | Professional | 52 · Reduced service | $109.65 | $162.18 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $64.57 Typical High $87.10 | Professional | 53 · Discontinued | $43.65 | $64.57 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $239.88 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $48.98 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $302.00 |
Where Idaho sits
The same service costs 4.4 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· 11th of 51
$363
AK $871UT $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.