How much rates vary
Facilitymedian $145 · 10th to 90th $48 to $501Professionalmedian $59 · 10th to 90th $43 to $135
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 $38.90 Median $64.57 Typical High $109.65 | Professional | None | $38.90 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $51.29 Typical High $81.28 | Professional | 54 · Surgery only | $35.48 | $51.29 | $81.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $64.57 Median $102.33 Typical High $354.81 | Facility | None | $64.57 | $102.33 | $354.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $147.91 | Professional | None | $46.77 | $54.95 | $147.91 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $104.71 Typical High $138.04 | Professional | 54 · Surgery only | $42.66 | $104.71 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $114.82 | Professional | None | $43.65 | $58.88 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $100.00 Typical High $5,495.41 | Facility | None | $38.90 | $100.00 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $138.04 | Professional | None | $41.69 | $67.61 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $81.28 | Professional | 54 · Surgery only | $35.48 | $35.48 | $81.28 |
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 $42.66 Typical High $117.49 | Facility | None | $39.81 | $42.66 | $117.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $138.04 | Professional | None | $42.66 | $51.29 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $36.31 Typical High $85.11 | Professional | 54 · Surgery only | $36.31 | $36.31 | $85.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $138.04 | Professional | None | $46.77 | $64.57 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $67.61 | Facility | None | $66.07 | $66.07 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
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 $34.67 Median $60.26 Typical High $117.49 | Professional | None | $34.67 | $60.26 | $117.49 |
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 $23.99 Median $34.67 Typical High $54.95 | Professional | 52 · Reduced service | $23.99 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.80 Typical High $21.88 | Professional | 53 · Discontinued | $9.55 | $13.80 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.23 Typical High $16.22 | Professional | 55 · Aftercare only | $7.08 | $10.23 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.92 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.79 | $6.92 | $10.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.37 Typical High $14.13 | Professional | 55 · Aftercare only | $4.68 | $5.37 | $14.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $54.95 Median $64.57 Typical High $186.21 | Professional | 63 · Small infant | $54.95 | $64.57 | $186.21 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $36.31 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $31.62 | $36.31 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $23.99 Typical High $54.95 | Professional | 52 · Reduced service | $23.99 | $23.99 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $21.88 | Professional | 53 · Discontinued | $9.55 | $9.55 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $16.22 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $10.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $12.02 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $38.90 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $38.90 | $38.90 | $91.20 |
Where Idaho sits
The same service costs 3.3 times more in Alaska 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· 16th of 51
$75.86
AK $155KY $46.77
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.