How much rates vary
Facilitymedian $589 · 10th to 90th $363 to $1,514Professionalmedian $912 · 10th to 90th $589 to $1,175
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,288.25 | Professional | None | $812.83 | $1,071.52 | $1,288.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $398.11 Median $676.08 Typical High $1,513.56 | Facility | None | $398.11 | $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 $331.13 Median $371.54 Typical High $501.19 | Facility | None | $331.13 | $371.54 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $831.76 | Professional | None | $416.87 | $741.31 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $5,495.41 | Facility | None | $501.19 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,148.15 | Professional | None | $707.95 | $933.25 | $1,148.15 |
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 $851.14 Median $851.14 Typical High $1,047.13 | Facility | None | $851.14 | $851.14 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | None | $741.31 | $912.01 | $1,318.26 |
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 $1,047.13 | Professional | None | $831.76 | $977.24 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $1,230.27 | Facility | None | $501.19 | $512.86 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $891.25 | Professional | None | $269.15 | $501.19 | $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 $741.31 Typical High $1,047.13 | Professional | None | $537.03 | $741.31 | $1,047.13 |
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 $407.38 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $213.80 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $602.56 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $123.03 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $107.15 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $562.34 | $741.31 | $794.33 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $588.84 Median $933.25 Typical High $2,290.87 | Facility | 50 · Both sides | $588.84 | $933.25 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,995.26 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $851.14 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $131.83 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $131.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,288.25 Typical High $1,479.11 | Professional | 63 · Small infant | $933.25 | $1,288.25 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $537.03 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $213.80 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $213.80 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $602.56 | $794.33 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $123.03 | $158.49 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $107.15 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $107.15 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $562.34 | $741.31 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $1,862.09 Typical High $1,995.26 | Professional | 50 · Both sides | $1,862.09 | $1,862.09 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $870.96 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $977.24 |
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· 15th of 51
$871
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.