How much rates vary
Facilitymedian $170 · 10th to 90th $44 to $1,622Professionalmedian $54 · 10th to 90th $40 to $112
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 $33.88 Median $45.71 Typical High $89.13 | Professional | None | $33.88 | $45.71 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $41.69 Typical High $67.61 | Professional | 54 · Surgery only | $32.36 | $41.69 | $67.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $51.29 Median $239.88 Typical High $1,621.81 | Facility | None | $51.29 | $239.88 | $1,621.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $125.89 | Professional | None | $41.69 | $89.13 | $125.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $45.71 Typical High $100.00 | Professional | 54 · Surgery only | $38.90 | $45.71 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $63.10 | Facility | None | $41.69 | $46.77 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $91.20 | Professional | None | $38.90 | $54.95 | $91.20 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $77.62 Typical High $5,495.41 | Facility | None | $34.67 | $77.62 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $112.20 | Professional | None | $39.81 | $53.70 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $67.61 | Professional | 54 · Surgery only | $32.36 | $32.36 | $67.61 |
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 $39.81 Median $41.69 Typical High $100.00 | Facility | None | $39.81 | $41.69 | $100.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $41.69 Median $69.18 Typical High $117.49 | Professional | None | $41.69 | $69.18 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $70.79 | Professional | 54 · Surgery only | $33.11 | $33.11 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $112.20 | Professional | None | $41.69 | $57.54 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $575.44 | Facility | None | $54.95 | $56.23 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
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 $30.90 Median $52.48 Typical High $91.20 | Professional | None | $30.90 | $52.48 | $91.20 |
13 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 $21.88 Median $28.18 Typical High $44.67 | Professional | 52 · Reduced service | $21.88 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.22 Typical High $17.78 | Professional | 53 · Discontinued | $8.71 | $11.22 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.32 Typical High $13.49 | Professional | 55 · Aftercare only | $6.46 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.62 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.37 | $5.62 | $8.91 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.79 Typical High $12.59 | Professional | 55 · Aftercare only | $4.37 | $4.79 | $12.59 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $53.70 Median $63.10 Typical High $144.54 | Professional | 63 · Small infant | $53.70 | $63.10 | $144.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.90 Median $36.31 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $30.90 | $36.31 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $44.67 | Professional | 52 · Reduced service | $21.88 | $21.88 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $17.78 | Professional | 53 · Discontinued | $8.71 | $8.71 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $13.49 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $8.91 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $10.00 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $35.48 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $35.48 | $35.48 | $75.86 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 15th of 51
$61.66
AK $138NJ $41.69
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.