How much rates vary
Facilitymedian $251 · 10th to 90th $47 to $1,202Professionalmedian $66 · 10th to 90th $39 to $89
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $74.13 Typical High $89.13 | Professional | None | $33.88 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $54.95 Typical High $67.61 | Professional | 54 · Surgery only | $47.86 | $54.95 | $67.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $43.65 Median $302.00 Typical High $1,202.26 | Facility | None | $43.65 | $302.00 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $91.20 | Professional | None | $54.95 | $75.86 | $91.20 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $70.79 Typical High $83.18 | Professional | 54 · Surgery only | $53.70 | $70.79 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $53.70 Typical High $66.07 | Professional | None | $32.36 | $53.70 | $66.07 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $74.13 Typical High $4,466.84 | Facility | None | $38.90 | $74.13 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $89.13 | Professional | None | $40.74 | $69.18 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $54.95 Typical High $67.61 | Professional | 54 · Surgery only | $47.86 | $54.95 | $67.61 |
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 $57.54 Median $57.54 Typical High $81.28 | Facility | None | $57.54 | $57.54 | $81.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $102.33 | Professional | None | $50.12 | $70.79 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | 54 · Surgery only | $58.88 | $58.88 | $72.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,318.26 | Facility | None | $524.81 | $891.25 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $83.18 | Professional | None | $56.23 | $69.18 | $83.18 |
Select Health Setting Facility Modifier None Typical Low $38.90 Median $39.81 Typical High $151.36 | Facility | None | $38.90 | $39.81 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $61.66 | Professional | None | $38.90 | $38.90 | $61.66 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $77.62 | Professional | None | $38.02 | $51.29 | $77.62 |
16 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 $31.62 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $31.62 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $12.59 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $9.55 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $8.91 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $60.26 Median $181.97 Typical High $1,174.90 | Facility | 50 · Both sides | $60.26 | $181.97 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $97.72 Typical High $131.83 | Professional | 50 · Both sides | $83.18 | $97.72 | $131.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.94 Typical High $9.12 | Professional | 55 · Aftercare only | $5.37 | $7.94 | $9.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $63.10 Median $91.20 Typical High $107.15 | Professional | 63 · Small infant | $63.10 | $91.20 | $107.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $54.95 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $41.69 | $54.95 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $31.62 | $36.31 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $12.59 | $14.79 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $9.55 | $10.96 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $8.91 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 50 · Both sides | $125.89 | $125.89 | $154.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $63.10 | $63.10 | $77.62 |
Where Idaho sits
The same service costs 3.8 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· 9th of 51
$67.61
AK $135UT $35.48
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.