How much rates vary
Facilitymedian $4,571 · 10th to 90th $427 to $18,621Professionalmedian $550 · 10th to 90th $331 to $724
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 $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | None | $302.00 | $331.13 | $371.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $21,877.62 | Facility | None | $4,897.79 | $5,128.61 | $21,877.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $776.25 | Professional | None | $549.54 | $660.69 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $331.13 Typical High $5,495.41 | Facility | None | $302.00 | $331.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $630.96 | Professional | None | $302.00 | $331.13 | $630.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $371.54 Median $426.58 Typical High $602.56 | Facility | None | $371.54 | $426.58 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $707.95 | Professional | None | $371.54 | $426.58 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $346.74 | Facility | None | $338.84 | $338.84 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $4,168.69 | Professional | None | $338.84 | $371.54 | $4,168.69 |
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 $407.38 Median $549.54 Typical High $724.44 | Professional | None | $407.38 | $549.54 | $724.44 |
11 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 $151.36 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $33.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $512.86 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $151.36 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $60.26 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $223.87 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $33.11 |
Where Idaho sits
The same service costs 4.5 times more in Alaska than in New York. 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· 13th of 51
$550
AK $1,479NY $331
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.