How much rates vary
Facilitymedian $537 · 10th to 90th $251 to $2,630Professionalmedian $339 · 10th to 90th $209 to $603
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 $158.49 Median $338.84 Typical High $602.56 | Professional | None | $158.49 | $338.84 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $2,630.27 | Facility | None | $407.38 | $562.34 | $2,630.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $602.56 | Professional | None | $251.19 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $251.19 Typical High $346.74 | Facility | None | $223.87 | $251.19 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $446.68 | Professional | None | $186.21 | $245.47 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $602.56 Typical High $4,466.84 | Facility | None | $234.42 | $602.56 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $602.56 | Professional | None | $190.55 | $338.84 | $602.56 |
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 $263.03 Median $426.58 Typical High $537.03 | Facility | None | $263.03 | $426.58 | $537.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $426.58 Typical High $691.83 | Professional | None | $229.09 | $426.58 | $691.83 |
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 $263.03 Median $331.13 Typical High $562.34 | Professional | None | $263.03 | $331.13 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $645.65 | Facility | None | $257.04 | $263.03 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $426.58 | Professional | None | $186.21 | $257.04 | $426.58 |
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 $169.82 Median $302.00 Typical High $501.19 | Professional | None | $169.82 | $302.00 | $501.19 |
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 $169.82 Median $169.82 Typical High $302.00 | Professional | 52 · Reduced service | $169.82 | $169.82 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $120.23 | Professional | 53 · Discontinued | $67.61 | $67.61 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $457.09 | Professional | 54 · Surgery only | $251.19 | $251.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $91.20 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $426.58 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $537.03 Median $933.25 Typical High $3,981.07 | Facility | 50 · Both sides | $537.03 | $933.25 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $588.84 Typical High $912.01 | Professional | 50 · Both sides | $380.19 | $588.84 | $912.01 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $269.15 Typical High $467.74 | Professional | 54 · Surgery only | $218.78 | $269.15 | $467.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $57.54 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $57.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $295.12 Median $467.74 Typical High $724.44 | Professional | 63 · Small infant | $295.12 | $467.74 | $724.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $302.00 | Professional | 52 · Reduced service | $169.82 | $169.82 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $120.23 | Professional | 53 · Discontinued | $67.61 | $67.61 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $457.09 | Professional | 54 · Surgery only | $251.19 | $251.19 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $91.20 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $588.84 Typical High $1,047.13 | Professional | 50 · Both sides | $588.84 | $588.84 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $478.63 | Professional | 54 · Surgery only | $275.42 | $275.42 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $69.18 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $69.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $512.86 |
Where Idaho sits
The same service costs 3.8 times more in Wyoming 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· 10th of 51
$355
WY $741KY $195
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.