How much rates vary
Facilitymedian $1,072 · 10th to 90th $288 to $5,495Professionalmedian $417 · 10th to 90th $269 to $661
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 $416.87 Median $489.78 Typical High $660.69 | Professional | None | $416.87 | $489.78 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $309.03 Median $1,479.11 Typical High $6,025.60 | Facility | None | $309.03 | $1,479.11 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $676.08 | Professional | None | $338.84 | $501.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $398.11 | Facility | None | $263.03 | $295.12 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $489.78 | Professional | None | $229.09 | $309.03 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $602.56 Typical High $5,495.41 | Facility | None | $288.40 | $602.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $660.69 | Professional | None | $302.00 | $416.87 | $660.69 |
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 $354.81 Median $354.81 Typical High $602.56 | Facility | None | $354.81 | $354.81 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $758.58 | Professional | None | $309.03 | $524.81 | $758.58 |
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 $331.13 Median $416.87 Typical High $616.60 | Professional | None | $331.13 | $416.87 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $3,890.45 | Facility | None | $288.40 | $295.12 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $380.19 | Professional | None | $213.80 | $288.40 | $380.19 |
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 $213.80 Median $338.84 Typical High $549.54 | Professional | None | $213.80 | $338.84 | $549.54 |
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 $208.93 Median $208.93 Typical High $331.13 | Professional | 52 · Reduced service | $208.93 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $100.00 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $457.09 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $467.74 Median $2,137.96 Typical High $9,120.11 | Facility | 50 · Both sides | $467.74 | $2,137.96 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $741.31 Typical High $954.99 | Professional | 50 · Both sides | $489.78 | $741.31 | $954.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $575.44 | Professional | 54 · Surgery only | $302.00 | $354.81 | $575.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $32.36 | $39.81 | $64.57 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $389.05 Median $588.84 Typical High $812.83 | Professional | 63 · Small infant | $389.05 | $588.84 | $812.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $346.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $229.09 | $346.74 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $331.13 | Professional | 52 · Reduced service | $208.93 | $208.93 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $85.11 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $316.23 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $100.00 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Professional | 50 · Both sides | $741.31 | $741.31 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $524.81 | Professional | 54 · Surgery only | $346.74 | $346.74 | $524.81 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $75.86 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $75.86 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $562.34 |
Where Idaho sits
The same service costs 4.2 times more in Wyoming 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· 11th of 51
$417
WY $912UT $219
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.