How much rates vary
Facilitymedian $151 · 10th to 90th $66 to $603Professionalmedian $117 · 10th to 90th $65 to $191
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $104.71 | Professional | None | $64.57 | $95.50 | $104.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $69.18 Median $234.42 Typical High $602.56 | Facility | None | $69.18 | $234.42 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $218.78 | Professional | None | $97.72 | $128.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $91.20 | Facility | None | $60.26 | $67.61 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $5,495.41 | Facility | None | $64.57 | $95.50 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $177.83 | Professional | None | $64.57 | $95.50 | $177.83 |
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 $93.33 Median $93.33 Typical High $162.18 | Facility | None | $93.33 | $93.33 | $162.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $173.78 | Professional | None | $117.49 | $173.78 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $147.91 | Professional | None | $97.72 | $112.20 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $97.72 | Facility | None | $95.50 | $95.50 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | None | $95.50 | $95.50 | $125.89 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $173.78 | Professional | None | $72.44 | $112.20 | $173.78 |
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 $32.36 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $32.36 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $12.88 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $47.86 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $9.55 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $9.55 | $9.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $89.13 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $74.13 | $89.13 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $38.02 Typical High $47.86 | Professional | 52 · Reduced service | $32.36 | $38.02 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $12.88 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $57.54 Typical High $70.79 | Professional | 54 · Surgery only | $47.86 | $57.54 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.48 Typical High $14.45 | Professional | 55 · Aftercare only | $9.55 | $11.48 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $7.59 | $9.55 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $123.03 | Professional | 54 · Surgery only | $81.28 | $81.28 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $17.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $131.83 |
Where Idaho sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 28th of 51
$117
AK $263VA $77.62
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.