How much rates vary
Facilitymedian $1,072 · 10th to 90th $550 to $4,677Professionalmedian $1,585 · 10th to 90th $1,072 to $2,291
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 $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $5,011.87 | Facility | None | $3,981.07 | $4,466.84 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,862.09 | $2,089.30 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,584.89 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,584.89 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $5,495.41 | Facility | None | $1,000.00 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,071.52 | $2,041.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $741.31 |
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 $1,148.15 Median $1,318.26 Typical High $1,862.09 | Facility | None | $1,148.15 | $1,318.26 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,318.26 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,548.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,862.09 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,122.02 | Facility | None | $1,047.13 | $1,047.13 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,047.13 | $2,187.76 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,584.89 | $2,398.83 |
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 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $741.31 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 22 · Increased work | $2,290.87 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $1,288.25 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 63 · Small infant | $2,290.87 | $2,290.87 | $2,290.87 |
Where Idaho sits
The same service costs 16.2 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
$1,585
AK $3,090TX $191
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.