How much rates vary
Facilitymedian $1,445 · 10th to 90th $977 to $6,026Professionalmedian $977 · 10th to 90th $603 to $1,230
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | None | $870.96 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,096.48 Median $2,238.72 Typical High $6,025.60 | Facility | None | $1,096.48 | $2,238.72 | $6,025.60 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,621.81 Median $2,511.89 Typical High $9,120.11 | Facility | 50 · Both sides | $1,621.81 | $2,511.89 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,412.54 | Professional | None | $912.01 | $1,096.48 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,621.81 Typical High $2,137.96 | Professional | 50 · Both sides | $1,348.96 | $1,621.81 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $891.25 | Professional | None | $436.52 | $794.33 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,230.27 Typical High $5,495.41 | Facility | None | $575.44 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,230.27 | Professional | None | $831.76 | $954.99 | $1,230.27 |
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 $794.33 Median $977.24 Typical High $977.24 | Facility | None | $794.33 | $977.24 | $977.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,412.54 | Professional | None | $851.14 | $977.24 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $7,585.78 | Facility | None | $3,890.45 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | None | $954.99 | $1,148.15 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $478.63 Typical High $3,890.45 | Facility | None | $467.74 | $478.63 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,445.44 | Professional | None | $467.74 | $724.44 | $1,445.44 |
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 $562.34 Median $758.58 Typical High $1,071.52 | Professional | None | $562.34 | $758.58 | $1,071.52 |
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 $436.52 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $436.52 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $173.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $645.65 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $87.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $602.56 | $870.96 | $870.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $1,288.25 | Professional | 54 · Surgery only | $794.33 | $954.99 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $141.25 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $141.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,071.52 Median $1,258.93 Typical High $1,698.24 | Professional | 63 · Small infant | $1,071.52 | $1,258.93 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $177.83 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $660.69 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $131.83 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $616.60 | $870.96 | $870.96 |
Where Idaho sits
The same service costs 8.5 times more in Wyoming 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· 12th of 51
$1,072
WY $2,512UT $295
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.