How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,202 to $5,754Professionalmedian $1,096 · 10th to 90th $575 to $1,622
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $6,025.60 | Facility | None | $1,621.81 | $2,630.27 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,548.82 | Professional | None | $630.96 | $741.31 | $1,548.82 |
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 $575.44 Median $1,047.13 Typical High $1,174.90 | Professional | None | $575.44 | $1,047.13 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $5,495.41 | Facility | None | $741.31 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $1,621.81 | Professional | None | $954.99 | $1,621.81 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $537.03 Typical High $630.96 | Professional | None | $30.20 | $537.03 | $630.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,258.93 | $1,258.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,248.07 Typical High $7,585.78 | Facility | None | $4,073.80 | $5,248.07 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $4,786.30 | Facility | None | $741.31 | $741.31 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,698.24 | Professional | None | $741.31 | $741.31 | $1,698.24 |
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 $758.58 Median $1,023.29 Typical High $1,445.44 | Professional | None | $758.58 | $1,023.29 | $1,445.44 |
18 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 $575.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $851.14 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $794.33 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,398.83 Median $3,715.35 Typical High $9,120.11 | Facility | 50 · Both sides | $2,398.83 | $3,715.35 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,047.13 Typical High $1,096.48 | Professional | 50 · Both sides | $933.25 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $562.34 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $147.91 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $741.31 Median $831.76 Typical High $891.25 | Professional | 63 · Small infant | $741.31 | $831.76 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $1,122.02 | $1,122.02 |
Where Idaho sits
The same service costs 4.6 times more in Alaska than in New York. 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· 17th of 51
$1,259
AK $3,090NY $676
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.