How much rates vary
Facilitymedian $12,589 · 10th to 90th $1,096 to $33,884Professionalmedian $1,000 · 10th to 90th $692 to $1,230
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 $1,318.26 Median $4,466.84 Typical High $7,762.47 | Facility | None | $1,318.26 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,096.48 | Professional | None | $616.60 | $1,096.48 | $1,096.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $14,791.08 Median $20,417.38 Typical High $39,810.72 | Facility | None | $14,791.08 | $20,417.38 | $39,810.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,122.02 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $11,481.54 Median $12,882.50 Typical High $17,378.01 | Facility | None | $11,481.54 | $12,882.50 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,071.52 | Professional | None | $776.25 | $933.25 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,318.26 Typical High $5,495.41 | Facility | None | $794.33 | $1,318.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,096.48 | Professional | None | $794.33 | $1,071.52 | $1,096.48 |
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 $891.25 Median $1,023.29 Typical High $1,023.29 | Facility | None | $891.25 | $1,023.29 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $2,137.96 | Professional | None | $954.99 | $1,023.29 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $24,547.09 Median $33,884.42 Typical High $42,657.95 | Facility | None | $24,547.09 | $33,884.42 | $42,657.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,000.00 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Facility | None | $524.81 | $524.81 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $812.83 | Professional | None | $524.81 | $524.81 | $812.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,288.25 | Professional | None | $676.08 | $891.25 | $1,288.25 |
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 $309.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $309.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $123.03 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $467.74 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $93.33 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $61.66 | $109.65 | $109.65 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $22,387.21 Median $22,908.68 Typical High $60,255.96 | Facility | 50 · Both sides | $22,387.21 | $22,908.68 | $60,255.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,398.83 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $123.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,412.54 Typical High $1,479.11 | Professional | 63 · Small infant | $1,174.90 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $398.11 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $602.56 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $120.23 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $109.65 | $109.65 |
Where Idaho sits
The same service costs 11.7 times more in Oklahoma 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· 19th of 51
$1,096
OK $4,786UT $407
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.