How much rates vary
Facilitymedian $1,549 · 10th to 90th $282 to $5,754Professionalmedian $234 · 10th to 90th $138 to $380
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 $131.83 Median $234.42 Typical High $380.19 | Professional | None | $131.83 | $234.42 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,698.24 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $389.05 | Professional | None | $186.21 | $275.42 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $281.84 | Professional | None | $125.89 | $173.78 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $338.84 Typical High $5,495.41 | Facility | None | $91.20 | $338.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $380.19 | Professional | None | $162.18 | $234.42 | $380.19 |
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 $190.55 Median $190.55 Typical High $346.74 | Facility | None | $190.55 | $190.55 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $436.52 | Professional | None | $165.96 | $302.00 | $436.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,754.40 Typical High $7,585.78 | Facility | None | $4,073.80 | $5,754.40 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $354.81 | Professional | None | $186.21 | $239.88 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $169.82 Typical High $4,786.30 | Facility | None | $165.96 | $169.82 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $1,698.24 | Professional | None | $165.96 | $199.53 | $1,698.24 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $302.00 | Professional | None | $117.49 | $186.21 | $302.00 |
22 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 $117.49 Median $117.49 Typical High $190.55 | Professional | 52 · Reduced service | $117.49 | $117.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $75.86 | Professional | 53 · Discontinued | $46.77 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $177.83 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $269.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,659.59 Median $2,570.40 Typical High $9,120.11 | Facility | 50 · Both sides | $1,659.59 | $2,570.40 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $416.87 Typical High $575.44 | Professional | 50 · Both sides | $269.15 | $416.87 | $575.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $295.12 Typical High $398.11 | Professional | 54 · Surgery only | $162.18 | $295.12 | $398.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $35.48 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $257.04 Typical High $467.74 | Professional | 63 · Small infant | $213.80 | $257.04 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $229.09 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $125.89 | $229.09 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $190.55 | Professional | 52 · Reduced service | $117.49 | $117.49 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $75.86 | Professional | 53 · Discontinued | $46.77 | $46.77 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $177.83 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $269.15 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $416.87 Typical High $660.69 | Professional | 50 · Both sides | $416.87 | $416.87 | $660.69 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $309.03 | Professional | 54 · Surgery only | $194.98 | $194.98 | $309.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $43.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $331.13 |
Where Idaho sits
The same service costs 4.8 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· 8th of 51
$257
AK $603KY $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.