How much rates vary
Facilitymedian $468 · 10th to 90th $224 to $1,514Professionalmedian $537 · 10th to 90th $380 to $741
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 $354.81 Median $588.84 Typical High $954.99 | Professional | None | $354.81 | $588.84 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $234.42 Median $676.08 Typical High $1,513.56 | Facility | None | $234.42 | $676.08 | $1,513.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $676.08 | Professional | None | $446.68 | $549.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $302.00 | Facility | None | $199.53 | $223.87 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $524.81 | Professional | None | $380.19 | $426.58 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $630.96 Typical High $5,495.41 | Facility | None | $281.84 | $630.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $676.08 | Professional | None | $389.05 | $524.81 | $676.08 |
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 $467.74 Median $467.74 Typical High $588.84 | Facility | None | $467.74 | $467.74 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $741.31 | Professional | None | $407.38 | $512.86 | $741.31 |
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 $457.09 Median $549.54 Typical High $588.84 | Professional | None | $457.09 | $549.54 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $1,230.27 | Facility | None | $281.84 | $288.40 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $489.78 | Professional | None | $162.18 | $281.84 | $489.78 |
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 $295.12 Median $549.54 Typical High $1,096.48 | Professional | None | $295.12 | $549.54 | $1,096.48 |
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 $229.09 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $446.68 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $346.74 Median $977.24 Typical High $2,290.87 | Facility | 50 · Both sides | $346.74 | $977.24 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $831.76 Typical High $1,023.29 | Professional | 50 · Both sides | $676.08 | $831.76 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $398.11 | $501.19 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $53.70 Typical High $67.61 | Professional | 55 · Aftercare only | $43.65 | $53.70 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $524.81 Median $630.96 Typical High $891.25 | Professional | 63 · Small infant | $524.81 | $630.96 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $295.12 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $117.49 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $436.52 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $446.68 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | 50 · Both sides | $1,023.29 | $1,023.29 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $478.63 | $512.86 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $74.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $549.54 |
Where Idaho sits
The same service costs 5.0 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· 21st of 51
$525
AK $1,096UT $219
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.