How much rates vary
Facilitymedian $603 · 10th to 90th $363 to $1,585Professionalmedian $891 · 10th to 90th $562 to $1,148
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 $575.44 Median $1,071.52 Typical High $1,230.27 | Professional | None | $575.44 | $1,071.52 | $1,230.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $380.19 Median $676.08 Typical High $1,513.56 | Facility | None | $380.19 | $676.08 | $1,513.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,230.27 | Professional | None | $812.83 | $977.24 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $489.78 | Facility | None | $323.59 | $363.08 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $724.44 Typical High $812.83 | Professional | None | $407.38 | $724.44 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $5,495.41 | Facility | None | $436.52 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,122.02 | Professional | None | $602.56 | $851.14 | $1,122.02 |
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 $831.76 Median $851.14 Typical High $1,023.29 | Facility | None | $831.76 | $851.14 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Professional | None | $741.31 | $891.25 | $1,288.25 |
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 $831.76 Median $977.24 Typical High $1,023.29 | Professional | None | $831.76 | $977.24 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,230.27 | Facility | None | $489.78 | $489.78 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $891.25 | Professional | None | $263.03 | $489.78 | $891.25 |
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 $537.03 Median $707.95 Typical High $1,000.00 | Professional | None | $537.03 | $707.95 | $1,000.00 |
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 $389.05 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $549.54 | $741.31 | $776.25 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $575.44 Median $977.24 Typical High $2,290.87 | Facility | 50 · Both sides | $575.44 | $977.24 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,445.44 Typical High $1,862.09 | Professional | 50 · Both sides | $1,174.90 | $1,445.44 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $851.14 Typical High $1,148.15 | Professional | 54 · Surgery only | $707.95 | $851.14 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $128.82 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,174.90 Typical High $1,548.82 | Professional | 63 · Small infant | $933.25 | $1,174.90 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $537.03 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $213.80 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $794.33 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $158.49 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $107.15 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $549.54 | $741.31 | $776.25 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $1,862.09 Typical High $1,905.46 | Professional | 50 · Both sides | $1,862.09 | $1,862.09 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $870.96 | $870.96 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $954.99 |
Where Idaho sits
The same service costs 6.2 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· 10th of 51
$851
AK $1,995UT $324
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.