How much rates vary
Facilitymedian $1,549 · 10th to 90th $37 to $5,888Professionalmedian $871 · 10th to 90th $37 to $2,239
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 Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,202.26 | Professional | None | $758.58 | $870.96 | $1,202.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $6,309.57 | Facility | None | $2,290.87 | $3,715.35 | $6,309.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $2,818.38 | Professional | None | $52.48 | $67.61 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $37.15 Median $1,023.29 Typical High $1,348.96 | Facility | None | $37.15 | $1,023.29 | $1,348.96 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $870.96 Typical High $1,584.89 | Professional | None | $54.95 | $870.96 | $1,584.89 |
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 $32.36 Median $52.48 Typical High $2,137.96 | Facility | None | $32.36 | $52.48 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $32.36 Median $67.61 Typical High $2,041.74 | Professional | None | $32.36 | $67.61 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $4,073.80 Typical High $6,309.57 | Facility | None | $2,290.87 | $4,073.80 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $107.15 Typical High $2,089.30 | Professional | None | $42.66 | $107.15 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Facility | None | $1,258.93 | $1,258.93 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $1,258.93 | Professional | None | $33.88 | $63.10 | $1,258.93 |
United Setting Professional Modifier None Typical Low $26.92 Median $891.25 Typical High $1,698.24 | Professional | None | $26.92 | $891.25 | $1,698.24 |
12 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 $512.86 Median $512.86 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | 53 · Discontinued | $204.17 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $134.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $46.77 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $42.66 | $46.77 | $1,905.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $512.86 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | 53 · Discontinued | $204.17 | $204.17 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $1,445.44 | Professional | 54 · Surgery only | $42.66 | $42.66 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $45.71 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $45.71 | $45.71 | $1,548.82 |
Where Idaho sits
The same service costs 49.0 times more in Hawaii than in Maryland. 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· 35th of 51
$871
HI $1,622MD $33.11
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.