How much rates vary
Facilitymedian $3,981 · 10th to 90th $776 to $12,882Professionalmedian $589 · 10th to 90th $407 to $724
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 $776.25 Median $2,884.03 Typical High $7,762.47 | Facility | None | $776.25 | $2,884.03 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $645.65 | Professional | None | $371.54 | $446.68 | $645.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $4,897.79 Typical High $14,791.08 | Facility | None | $3,548.13 | $4,897.79 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $831.76 | Professional | None | $575.44 | $660.69 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $776.25 Typical High $5,495.41 | Facility | None | $407.38 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $724.44 | Professional | None | $436.52 | $645.65 | $724.44 |
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 $524.81 Median $645.65 Typical High $645.65 | Facility | None | $524.81 | $645.65 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,122.02 | Professional | None | $645.65 | $645.65 | $1,122.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $724.44 | Professional | None | $575.44 | $575.44 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $10,232.93 | Facility | None | $309.03 | $316.23 | $10,232.93 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $467.74 | Professional | None | $309.03 | $309.03 | $467.74 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $741.31 | Professional | None | $363.08 | $537.03 | $741.31 |
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 $218.78 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $218.78 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $87.10 | $128.82 | $128.82 |
Aetna 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 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $64.57 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $43.65 | $64.57 | $64.57 |
Aetna 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 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $616.60 | $645.65 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $69.18 | $72.44 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | 62 · Two surgeons | $363.08 | $426.58 | $446.68 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $812.83 Typical High $870.96 | Professional | 63 · Small infant | $691.83 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $478.63 | $501.19 |
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 $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $87.10 | $128.82 | $128.82 |
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 $64.57 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $64.57 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $43.65 | $64.57 | $64.57 |
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 9.3 times more in Kansas 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· 19th of 51
$646
KS $2,818UT $302
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.