How much rates vary
Facilitymedian $525 · 10th to 90th $138 to $1,349Professionalmedian $182 · 10th to 90th $126 to $1,288
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $954.99 | Professional | None | $117.49 | $173.78 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $467.74 Typical High $660.69 | Facility | None | $229.09 | $467.74 | $660.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $870.96 Typical High $1,513.56 | Professional | None | $134.90 | $870.96 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $1,000.00 | Professional | None | $131.83 | $199.53 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $4,466.84 | Facility | None | $117.49 | $218.78 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $1,202.26 | Professional | None | $125.89 | $204.17 | $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 $138.04 Median $138.04 Typical High $1,258.93 | Facility | None | $138.04 | $138.04 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $1,288.25 | Professional | None | $138.04 | $147.91 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $1,202.26 | Professional | None | $134.90 | $234.42 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $676.08 | Facility | None | $281.84 | $660.69 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $831.76 | Professional | None | $97.72 | $138.04 | $831.76 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $15,488.17 Typical High $26,302.68 | Facility | None | $3,801.89 | $15,488.17 | $26,302.68 |
United Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $758.58 | Professional | None | $100.00 | $199.53 | $758.58 |
14 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 $58.88 Median $87.10 Typical High $478.63 | Professional | 52 · Reduced service | $58.88 | $87.10 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $190.55 | Professional | 53 · Discontinued | $23.44 | $34.67 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $131.83 Typical High $707.95 | Professional | 54 · Surgery only | $89.13 | $131.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $141.25 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $95.50 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $95.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $741.31 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $100.00 | $741.31 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $87.10 Typical High $478.63 | Professional | 52 · Reduced service | $58.88 | $87.10 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $190.55 | Professional | 53 · Discontinued | $23.44 | $34.67 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $131.83 Typical High $707.95 | Professional | 54 · Surgery only | $89.13 | $131.83 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $141.25 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $95.50 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $741.31 | Professional | 54 · Surgery only | $100.00 | $100.00 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $104.71 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $794.33 |
Where Idaho sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 34th of 51
$204
WA $933DC $97.72
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.