How much rates vary
Facilitymedian $141 · 10th to 90th $21 to $501Professionalmedian $28 · 10th to 90th $20 to $35
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $25.12 Typical High $29.51 | Professional | None | $16.22 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $18.62 Typical High $20.89 | Professional | 54 · Surgery only | $17.78 | $18.62 | $20.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $45.71 Median $81.28 Typical High $371.54 | Facility | None | $45.71 | $81.28 | $371.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $38.02 | Professional | None | $23.99 | $28.18 | $38.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $25.12 Typical High $36.31 | Professional | 54 · Surgery only | $21.38 | $25.12 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $25.70 Typical High $28.84 | Professional | None | $20.42 | $25.70 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $25.12 Typical High $4,466.84 | Facility | None | $17.38 | $25.12 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $21.38 Median $28.18 Typical High $35.48 | Professional | None | $21.38 | $28.18 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | 54 · Surgery only | $18.62 | $18.62 | $20.89 |
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 $20.89 Median $21.88 Typical High $30.90 | Facility | None | $20.89 | $21.88 | $30.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $36.31 | Professional | None | $21.88 | $27.54 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | 54 · Surgery only | $19.50 | $19.50 | $21.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $35.48 | Professional | None | $24.55 | $28.18 | $35.48 |
Select Health Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $169.82 | Facility | None | $17.38 | $17.38 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | None | $17.38 | $17.38 | $23.44 |
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 $17.38 Median $23.44 Typical High $31.62 | Professional | None | $17.38 | $23.44 | $31.62 |
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 $11.75 Median $12.59 Typical High $14.13 | Professional | 52 · Reduced service | $11.75 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $5.01 Typical High $5.62 | Professional | 53 · Discontinued | $4.68 | $5.01 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.72 Typical High $4.17 | Professional | 55 · Aftercare only | $3.55 | $3.72 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.51 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.34 | $2.51 | $2.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $3.16 Typical High $4.07 | Professional | 55 · Aftercare only | $2.40 | $3.16 | $4.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $28.84 Median $33.88 Typical High $38.02 | Professional | 63 · Small infant | $28.84 | $33.88 | $38.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.60 Median $20.42 Typical High $26.30 | Professional | 78 · Unplanned return to OR | $16.60 | $20.42 | $26.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $12.59 Typical High $14.13 | Professional | 52 · Reduced service | $12.59 | $12.59 | $14.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.62 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $4.17 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $4.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $3.16 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.89 Median $20.89 Typical High $23.44 | Professional | 78 · Unplanned return to OR | $20.89 | $20.89 | $23.44 |
Where Idaho sits
The same service costs 3.9 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· 8th of 51
$28.18
AK $64.57NJ $16.60
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.