How much rates vary
Facilitymedian $977 · 10th to 90th $575 to $4,571Professionalmedian $1,072 · 10th to 90th $759 to $1,288
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 $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | None | $691.83 | $1,202.26 | $1,202.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $2,884.03 Typical High $4,570.88 | Facility | None | $912.01 | $2,884.03 | $4,570.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,380.38 Median $4,073.80 Typical High $7,244.36 | Facility | 50 · Both sides | $1,380.38 | $4,073.80 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,454.71 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,148.15 | Professional | None | $831.76 | $977.24 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $5,495.41 | Facility | None | $645.65 | $1,202.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,202.26 | Professional | None | $912.01 | $1,122.02 | $1,202.26 |
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 $954.99 Median $1,071.52 Typical High $1,071.52 | Facility | None | $954.99 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,071.52 | $2,187.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,890.45 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,023.29 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $4,365.16 | Facility | None | $549.54 | $562.34 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $851.14 | Professional | None | $549.54 | $549.54 | $851.14 |
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 $676.08 Median $1,000.00 Typical High $1,412.54 | Professional | None | $676.08 | $1,000.00 | $1,412.54 |
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 $346.74 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $346.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $138.04 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $104.71 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $69.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $478.63 | $831.76 | $831.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,122.02 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $1,122.02 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $131.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,479.11 Typical High $1,548.82 | Professional | 63 · Small infant | $1,258.93 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $831.76 | $831.76 |
Where Idaho sits
The same service costs 5.9 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
$1,072
AK $2,692UT $457
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.