How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,479 to $14,125Professionalmedian $1,479 · 10th to 90th $1,023 to $1,778
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $1,659.59 | Professional | None | $954.99 | $1,659.59 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $15,135.61 | Facility | None | $3,388.44 | $5,248.07 | $15,135.61 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $7,585.78 Typical High $22,908.68 | Facility | 50 · Both sides | $4,897.79 | $7,585.78 | $22,908.68 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,570.40 Typical High $3,388.44 | Professional | 50 · Both sides | $2,137.96 | $2,570.40 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,348.96 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,659.59 Typical High $5,495.41 | Facility | None | $870.96 | $1,659.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,548.82 | $1,659.59 |
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 $1,288.25 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,288.25 | $1,479.11 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,479.11 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,412.54 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $10,964.78 | Facility | None | $758.58 | $776.25 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,174.90 | Professional | None | $758.58 | $758.58 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,905.46 | Professional | None | $891.25 | $1,348.96 | $1,905.46 |
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 $478.63 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $478.63 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $190.55 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $724.44 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $144.54 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $95.50 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $676.08 | $1,148.15 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,288.25 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,698.24 Median $2,041.74 Typical High $2,137.96 | Professional | 63 · Small infant | $1,698.24 | $2,041.74 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,174.90 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,174.90 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $616.60 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $933.25 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $186.21 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 7.2 times more in Alaska than in Texas. 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· 16th of 51
$1,660
AK $3,715TX $513
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.