How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $9,120Professionalmedian $1,778 · 10th to 90th $1,096 to $2,291
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 $1,318.26 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,318.26 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $10,000.00 | Facility | None | $1,949.84 | $3,548.13 | $10,000.00 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,884.03 Median $3,715.35 Typical High $15,135.61 | Facility | 50 · Both sides | $2,884.03 | $3,715.35 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,659.59 | $2,041.74 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,884.03 Typical High $3,981.07 | Professional | 50 · Both sides | $2,511.89 | $2,884.03 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,445.44 Typical High $1,659.59 | Professional | None | $758.58 | $1,445.44 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $5,495.41 | Facility | None | $954.99 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,778.28 | $2,290.87 |
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 $1,479.11 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,479.11 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,819.70 | $2,630.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,456.54 Median $9,120.11 Typical High $12,589.25 | Facility | None | $6,456.54 | $9,120.11 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,778.28 | $2,089.30 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $891.25 Typical High $6,918.31 | Facility | None | $870.96 | $891.25 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,238.72 | Professional | None | $870.96 | $1,348.96 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,412.54 | $1,995.26 |
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 $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $794.33 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $316.23 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,202.26 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,621.81 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,737.80 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,479.11 | $1,737.80 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $263.03 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $263.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,949.84 Median $2,344.23 Typical High $3,162.28 | Professional | 63 · Small infant | $1,949.84 | $2,344.23 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,348.96 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,348.96 | $1,862.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $812.83 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $323.59 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,230.27 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $245.47 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $162.18 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,621.81 | $1,621.81 |
Where Idaho sits
The same service costs 7.2 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· 14th of 51
$1,862
AK $4,266UT $589
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.