How much rates vary
Facilitymedian $234 · 10th to 90th $42 to $603Professionalmedian $54 · 10th to 90th $32 to $158
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 $41.69 Median $151.36 Typical High $5,495.41 | Facility | None | $41.69 | $151.36 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $54.95 Typical High $125.89 | Professional | None | $28.18 | $54.95 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $56.23 Typical High $95.50 | Professional | 54 · Surgery only | $26.30 | $56.23 | $95.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $64.57 Median $257.04 Typical High $602.56 | Facility | None | $64.57 | $257.04 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $169.82 | Professional | None | $33.11 | $107.15 | $169.82 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $38.90 Typical High $147.91 | Professional | 54 · Surgery only | $33.11 | $38.90 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $125.89 | Professional | None | $32.36 | $43.65 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $141.25 Typical High $1,412.54 | Facility | None | $34.67 | $141.25 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $158.49 | Professional | None | $32.36 | $60.26 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $26.30 Typical High $95.50 | Professional | 54 · Surgery only | $26.30 | $26.30 | $95.50 |
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 $32.36 Median $33.88 Typical High $134.90 | Facility | None | $32.36 | $33.88 | $134.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $33.88 Median $93.33 Typical High $158.49 | Professional | None | $33.88 | $93.33 | $158.49 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $26.30 Typical High $97.72 | Professional | 54 · Surgery only | $26.30 | $26.30 | $97.72 |
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 $33.11 Median $46.77 Typical High $158.49 | Professional | None | $33.11 | $46.77 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $77.62 Typical High $194.98 | Facility | None | $75.86 | $77.62 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
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 $25.12 Median $53.70 Typical High $107.15 | Professional | None | $25.12 | $53.70 | $107.15 |
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 $17.38 Median $37.15 Typical High $63.10 | Professional | 52 · Reduced service | $17.38 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $15.14 Typical High $25.12 | Professional | 53 · Discontinued | $7.08 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $11.22 Typical High $19.05 | Professional | 55 · Aftercare only | $5.25 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $7.41 Typical High $12.59 | Professional | 56 · Pre-op care only | $3.47 | $7.41 | $12.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.47 Typical High $17.38 | Professional | 55 · Aftercare only | $3.39 | $4.47 | $17.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $40.74 Median $53.70 Typical High $204.17 | Professional | 63 · Small infant | $40.74 | $53.70 | $204.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.30 Median $30.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $26.30 | $30.20 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $17.38 Typical High $63.10 | Professional | 52 · Reduced service | $17.38 | $17.38 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $25.12 | Professional | 53 · Discontinued | $7.08 | $7.08 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $19.05 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $12.59 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $14.13 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $14.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $28.18 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $28.18 | $28.18 | $104.71 |
Where Idaho sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 9th of 51
$85.11
WI $123KY $36.31
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.