How much rates vary
Facilitymedian $437 · 10th to 90th $263 to $617Professionalmedian $513 · 10th to 90th $295 to $813
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 $295.12 Median $338.84 Typical High $416.87 | Professional | None | $295.12 | $338.84 | $416.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $257.04 Median $338.84 Typical High $524.81 | Facility | None | $257.04 | $338.84 | $524.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,071.52 | Professional | None | $602.56 | $758.58 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $724.44 | Professional | None | $295.12 | $389.05 | $724.44 |
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 $380.19 Median $524.81 Typical High $794.33 | Facility | None | $380.19 | $524.81 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $812.83 | Professional | None | $380.19 | $549.54 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $524.81 | Facility | None | $257.04 | $371.54 | $524.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $707.95 | Professional | None | $501.19 | $602.56 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $478.63 | Facility | None | $467.74 | $467.74 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $758.58 | Professional | None | $398.11 | $467.74 | $758.58 |
United Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $630.96 | Professional | None | $316.23 | $436.52 | $630.96 |
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 $199.53 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $45.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $79.43 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $45.71 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $501.19 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $616.60 |
Where Idaho sits
The same service costs 2.1 times more in Wyoming 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· 11th of 51
$513
WY $661MD $309
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.