How much rates vary
Facilitymedian $550 · 10th to 90th $224 to $2,630Professionalmedian $240 · 10th to 90th $135 to $525
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 $144.54 Median $234.42 Typical High $524.81 | Professional | None | $144.54 | $234.42 | $524.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $263.03 Median $891.25 Typical High $2,630.27 | Facility | None | $263.03 | $891.25 | $2,630.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $524.81 | Professional | None | $162.18 | $316.23 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $251.19 Typical High $338.84 | Facility | None | $223.87 | $251.19 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $389.05 | Professional | None | $112.20 | $173.78 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $407.38 Typical High $5,495.41 | Facility | None | $89.13 | $407.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $524.81 | Professional | None | $144.54 | $234.42 | $524.81 |
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 $169.82 Median $169.82 Typical High $467.74 | Facility | None | $169.82 | $169.82 | $467.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $407.38 Typical High $588.84 | Professional | None | $147.91 | $407.38 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,584.89 | $2,290.87 | $3,311.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $478.63 | Professional | None | $162.18 | $316.23 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $1,148.15 | Facility | None | $223.87 | $223.87 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $295.12 | Professional | None | $177.83 | $223.87 | $295.12 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $407.38 | Professional | None | $104.71 | $204.17 | $407.38 |
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 $104.71 Median $120.23 Typical High $263.03 | Professional | 52 · Reduced service | $104.71 | $120.23 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $104.71 | Professional | 53 · Discontinued | $41.69 | $47.86 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $177.83 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $165.96 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $144.54 | $165.96 | $371.54 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $398.11 Median $1,318.26 Typical High $3,981.07 | Facility | 50 · Both sides | $398.11 | $1,318.26 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $645.65 Typical High $891.25 | Professional | 50 · Both sides | $239.88 | $645.65 | $891.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $141.25 | $389.05 | $537.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $24.55 Typical High $52.48 | Professional | 55 · Aftercare only | $15.85 | $24.55 | $52.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $295.12 Typical High $588.84 | Professional | 63 · Small infant | $213.80 | $295.12 | $588.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $134.90 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $109.65 | $134.90 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $263.03 | Professional | 52 · Reduced service | $104.71 | $104.71 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $104.71 | Professional | 53 · Discontinued | $41.69 | $41.69 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $154.88 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $363.08 Typical High $891.25 | Professional | 50 · Both sides | $363.08 | $363.08 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $416.87 | Professional | 54 · Surgery only | $169.82 | $169.82 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $58.88 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $446.68 |
Where Idaho sits
The same service costs 5.6 times more in Alaska than in Kentucky. 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
$263
AK $562KY $100
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.