How much rates vary
Facilitymedian $363 · 10th to 90th $162 to $891Professionalmedian $398 · 10th to 90th $251 to $513
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 $223.87 Median $457.09 Typical High $512.86 | Professional | None | $223.87 | $457.09 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $173.78 Median $354.81 Typical High $758.58 | Facility | None | $173.78 | $354.81 | $758.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $549.54 | Professional | None | $346.74 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $380.19 | Professional | None | $190.55 | $338.84 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $512.86 Typical High $5,495.41 | Facility | None | $229.09 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $512.86 | Professional | None | $316.23 | $416.87 | $512.86 |
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 $371.54 Median $371.54 Typical High $478.63 | Facility | None | $371.54 | $371.54 | $478.63 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $602.56 | Professional | None | $323.59 | $416.87 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $954.99 | Facility | None | $501.19 | $758.58 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $478.63 | Professional | None | $354.81 | $426.58 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $724.44 | Facility | None | $229.09 | $234.42 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $389.05 | Professional | None | $123.03 | $229.09 | $389.05 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $457.09 | Professional | None | $234.42 | $316.23 | $457.09 |
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 $186.21 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $186.21 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $74.13 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $275.42 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $37.15 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $257.04 | $323.59 | $363.08 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $263.03 Median $512.86 Typical High $1,148.15 | Facility | 50 · Both sides | $263.03 | $512.86 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $602.56 Typical High $891.25 | Professional | 50 · Both sides | $512.86 | $602.56 | $891.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $309.03 | $467.74 | $489.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $60.26 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $60.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $457.09 Median $549.54 Typical High $645.65 | Professional | 63 · Small infant | $457.09 | $549.54 | $645.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $239.88 | $323.59 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $186.21 | $229.09 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $74.13 | $91.20 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $275.42 | $346.74 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $37.15 | $45.71 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $257.04 | $323.59 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | 50 · Both sides | $794.33 | $794.33 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $371.54 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $60.26 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $446.68 |
Where Idaho sits
The same service costs 4.3 times more in Alaska than in Florida. 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
$398
AK $871FL $204
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.