How much rates vary
Facilitymedian $2,692 · 10th to 90th $851 to $10,471Professionalmedian $851 · 10th to 90th $537 to $1,072
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 $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | None | $758.58 | $1,071.52 | $1,071.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,951.21 Typical High $10,964.78 | Facility | None | $1,621.81 | $2,951.21 | $10,964.78 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $4,365.16 Typical High $16,982.44 | Facility | 50 · Both sides | $2,344.23 | $4,365.16 | $16,982.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,230.27 | Professional | None | $794.33 | $954.99 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,380.38 Typical High $1,862.09 | Professional | 50 · Both sides | $1,174.90 | $1,380.38 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $2,398.83 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $776.25 | Professional | None | $389.05 | $691.83 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $5,495.41 | Facility | None | $524.81 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,071.52 | Professional | None | $707.95 | $831.76 | $1,071.52 |
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 $691.83 Median $851.14 Typical High $851.14 | Facility | None | $691.83 | $851.14 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,230.27 | Professional | None | $741.31 | $851.14 | $1,230.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,471.29 Typical High $13,182.57 | Facility | None | $7,585.78 | $10,471.29 | $13,182.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | None | $831.76 | $1,000.00 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $5,495.41 | Facility | None | $407.38 | $416.87 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $2,951.21 | Professional | None | $407.38 | $630.96 | $2,951.21 |
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 $512.86 Median $691.83 Typical High $977.24 | Professional | None | $512.86 | $691.83 | $977.24 |
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 $380.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $562.34 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $524.81 | $741.31 | $741.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $812.83 Typical High $1,122.02 | Professional | 54 · Surgery only | $691.83 | $812.83 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $123.03 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $123.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $912.01 Median $1,096.48 Typical High $1,479.11 | Professional | 63 · Small infant | $912.01 | $1,096.48 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $114.82 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $537.03 | $741.31 | $741.31 |
Where Idaho sits
The same service costs 7.9 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· 13th of 51
$955
WY $2,344UT $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.