How much rates vary
Facilitymedian $575 · 10th to 90th $200 to $4,467Professionalmedian $251 · 10th to 90th $174 to $389
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $380.19 | Professional | None | $144.54 | $229.09 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $218.78 Median $1,348.96 Typical High $4,466.84 | Facility | None | $218.78 | $1,348.96 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $446.68 | Professional | None | $204.17 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $275.42 | Facility | None | $181.97 | $204.17 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $331.13 | Professional | None | $177.83 | $234.42 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $331.13 Typical High $5,495.41 | Facility | None | $134.90 | $331.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $380.19 | Professional | None | $190.55 | $239.88 | $380.19 |
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 $218.78 Median $218.78 Typical High $380.19 | Facility | None | $218.78 | $218.78 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $426.58 | Professional | None | $204.17 | $354.81 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $354.81 | Professional | None | $204.17 | $263.03 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $4,466.84 | Facility | None | $194.98 | $199.53 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $263.03 | Professional | None | $147.91 | $194.98 | $263.03 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $389.05 | Professional | None | $134.90 | $229.09 | $389.05 |
18 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 $87.10 Median $114.82 Typical High $186.21 | Professional | 52 · Reduced service | $87.10 | $114.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $75.86 | Professional | 53 · Discontinued | $34.67 | $45.71 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $281.84 | Professional | 54 · Surgery only | $128.82 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $56.23 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $38.02 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $263.03 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $323.59 Median $1,905.46 Typical High $6,760.83 | Facility | 50 · Both sides | $323.59 | $1,905.46 | $6,760.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $380.19 Typical High $645.65 | Professional | 50 · Both sides | $331.13 | $380.19 | $645.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $234.42 Typical High $407.38 | Professional | 54 · Surgery only | $194.98 | $234.42 | $407.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.30 Typical High $45.71 | Professional | 55 · Aftercare only | $22.39 | $26.30 | $45.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $257.04 Median $302.00 Typical High $549.54 | Professional | 63 · Small infant | $257.04 | $302.00 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $181.97 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $151.36 | $181.97 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $114.82 Typical High $186.21 | Professional | 52 · Reduced service | $87.10 | $114.82 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $75.86 | Professional | 53 · Discontinued | $34.67 | $45.71 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $281.84 | Professional | 54 · Surgery only | $128.82 | $173.78 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $56.23 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $38.02 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $263.03 |
Where Idaho sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 15th of 51
$269
OK $646KY $166
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.