How much rates vary
Facilitymedian $501 · 10th to 90th $195 to $1,413Professionalmedian $288 · 10th to 90th $182 to $457
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 $151.36 Median $245.47 Typical High $363.08 | Professional | None | $151.36 | $245.47 | $363.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $562.34 | Professional | None | $208.93 | $338.84 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $398.11 | Professional | None | $218.78 | $281.84 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $4,466.84 | Facility | None | $162.18 | $245.47 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $501.19 | Professional | None | $186.21 | $295.12 | $501.19 |
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 $281.84 Median $281.84 Typical High $457.09 | Facility | None | $281.84 | $281.84 | $457.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $457.09 | Professional | None | $281.84 | $281.84 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $457.09 | Professional | None | $208.93 | $309.03 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $251.19 | Facility | None | $234.42 | $234.42 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $323.59 | Professional | None | $194.98 | $234.42 | $323.59 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | None | $151.36 | $229.09 | $346.74 |
8 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 $97.72 Median $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $97.72 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $36.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $263.03 | $309.03 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $56.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $316.23 Median $416.87 Typical High $691.83 | Professional | 63 · Small infant | $316.23 | $416.87 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $194.98 | $239.88 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $97.72 | $123.03 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $36.31 |
Where Idaho sits
The same service costs 3.9 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· 12th of 51
$295
AK $589KY $151
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.