How much rates vary
Facilitymedian $646 · 10th to 90th $115 to $5,495Professionalmedian $275 · 10th to 90th $166 to $339
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 $147.91 Median $316.23 Typical High $338.84 | Professional | None | $147.91 | $316.23 | $338.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $645.65 Typical High $6,025.60 | Facility | None | $120.23 | $645.65 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $371.54 | Professional | None | $245.47 | $295.12 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $158.49 | Facility | None | $102.33 | $114.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $245.47 | Professional | None | $123.03 | $218.78 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $338.84 Typical High $5,495.41 | Facility | None | $147.91 | $338.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $338.84 | Professional | None | $204.17 | $263.03 | $338.84 |
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 $257.04 Median $257.04 Typical High $316.23 | Facility | None | $257.04 | $257.04 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | None | $223.87 | $275.42 | $389.05 |
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 $245.47 Median $295.12 Typical High $316.23 | Professional | None | $245.47 | $295.12 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $2,290.87 | Facility | None | $147.91 | $151.36 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $269.15 | Professional | None | $85.11 | $147.91 | $269.15 |
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 $162.18 Median $208.93 Typical High $295.12 | Professional | None | $162.18 | $208.93 | $295.12 |
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 $120.23 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $223.87 | $234.42 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $181.97 Median $851.14 Typical High $9,120.11 | Facility | 50 · Both sides | $181.97 | $851.14 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $436.52 Typical High $588.84 | Professional | 50 · Both sides | $354.81 | $436.52 | $588.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $213.80 | $257.04 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $37.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $295.12 Median $389.05 Typical High $446.68 | Professional | 63 · Small infant | $295.12 | $389.05 | $446.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $158.49 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $63.10 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $239.88 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $223.87 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | 50 · Both sides | $562.34 | $562.34 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $257.04 | $257.04 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $38.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $295.12 |
Where Idaho sits
The same service costs 4.6 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· 10th of 51
$275
AK $603FL $132
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.