How much rates vary
Facilitymedian $550 · 10th to 90th $363 to $1,514Professionalmedian $646 · 10th to 90th $380 to $832
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $758.58 Typical High $831.76 | Professional | None | $338.84 | $758.58 | $831.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $1,513.56 | Facility | None | $407.38 | $676.08 | $1,513.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $870.96 | Professional | None | $575.44 | $707.95 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $371.54 Typical High $501.19 | Facility | None | $331.13 | $371.54 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $537.03 Typical High $616.60 | Professional | None | $302.00 | $537.03 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $758.58 Typical High $5,495.41 | Facility | None | $331.13 | $758.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $831.76 | Professional | None | $398.11 | $645.65 | $831.76 |
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 $602.56 Median $602.56 Typical High $758.58 | Facility | None | $602.56 | $602.56 | $758.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,905.46 | Facility | None | $977.24 | $1,380.38 | $1,905.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $776.25 | Professional | None | $588.84 | $707.95 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $1,230.27 | Facility | None | $363.08 | $371.54 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $630.96 | Professional | None | $269.15 | $363.08 | $630.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $724.44 | Professional | None | $371.54 | $501.19 | $724.44 |
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 $302.00 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $302.00 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $120.23 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $446.68 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $89.13 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $416.87 | $524.81 | $588.84 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $588.84 Median $977.24 Typical High $2,290.87 | Facility | 50 · Both sides | $588.84 | $977.24 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,023.29 Typical High $1,318.26 | Professional | 50 · Both sides | $870.96 | $1,023.29 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $794.33 | Professional | 54 · Surgery only | $501.19 | $602.56 | $794.33 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $87.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $812.83 Typical High $1,047.13 | Professional | 63 · Small infant | $691.83 | $812.83 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $302.00 | $380.19 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $120.23 | $151.36 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $446.68 | $562.34 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $89.13 | $114.82 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $416.87 | $524.81 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,318.26 | $1,318.26 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $616.60 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $724.44 |
Where Idaho sits
The same service costs 5.6 times more in Alaska 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· 9th of 51
$646
AK $1,413UT $251
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.