How much rates vary
Facilitymedian $1,445 · 10th to 90th $759 to $5,495Professionalmedian $661 · 10th to 90th $389 to $1,023
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,023.29 | Professional | None | $478.63 | $660.69 | $1,023.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $6,025.60 | Facility | None | $1,412.54 | $2,290.87 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,047.13 | Professional | None | $524.81 | $776.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $758.58 | Professional | None | $338.84 | $489.78 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $776.25 Typical High $5,495.41 | Facility | None | $354.81 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,023.29 | Professional | None | $457.09 | $660.69 | $1,023.29 |
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 $549.54 Median $549.54 Typical High $933.25 | Facility | None | $549.54 | $549.54 | $933.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,174.90 | Professional | None | $478.63 | $812.83 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $7,585.78 | Facility | None | $3,890.45 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $954.99 | Professional | None | $512.86 | $660.69 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $457.09 Typical High $3,890.45 | Facility | None | $446.68 | $457.09 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,445.44 | Professional | None | $446.68 | $562.34 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $741.31 | Professional | None | $331.13 | $512.86 | $741.31 |
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 $331.13 Median $331.13 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $501.19 | $501.19 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $154.88 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $724.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,089.30 Median $3,388.44 Typical High $9,120.11 | Facility | 50 · Both sides | $2,089.30 | $3,388.44 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,174.90 Typical High $1,584.89 | Professional | 50 · Both sides | $758.58 | $1,174.90 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $1,071.52 | Professional | 54 · Surgery only | $457.09 | $549.54 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $52.48 | $100.00 | $117.49 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $602.56 Median $741.31 Typical High $1,412.54 | Professional | 63 · Small infant | $602.56 | $741.31 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $616.60 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $416.87 | $616.60 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $331.13 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $131.83 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $501.19 | $501.19 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $154.88 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $724.44 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,174.90 Typical High $1,778.28 | Professional | 50 · Both sides | $1,174.90 | $1,174.90 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $831.76 | Professional | 54 · Surgery only | $537.03 | $537.03 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $891.25 |
Where Idaho sits
The same service costs 5.9 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· 8th of 51
$708
AK $1,698UT $288
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.