How much rates vary
Facilitymedian $117 · 10th to 90th $42 to $398Professionalmedian $47 · 10th to 90th $35 to $85
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 $35.48 Median $66.07 Typical High $5,495.41 | Facility | None | $35.48 | $66.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $77.62 | Professional | None | $29.51 | $45.71 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $33.88 Typical High $57.54 | Professional | 54 · Surgery only | $32.36 | $33.88 | $57.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $186.21 | Facility | None | $56.23 | $107.15 | $186.21 |
BCBS Idaho Setting Professional Modifier None Typical Low $35.48 Median $58.88 Typical High $93.33 | Professional | None | $35.48 | $58.88 | $93.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $39.81 Typical High $89.13 | Professional | 54 · Surgery only | $34.67 | $39.81 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $70.79 | Professional | None | $34.67 | $44.67 | $70.79 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $61.66 Typical High $1,412.54 | Facility | None | $35.48 | $61.66 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $85.11 | Professional | None | $35.48 | $46.77 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $57.54 | Professional | 54 · Surgery only | $32.36 | $32.36 | $57.54 |
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 $34.67 Median $36.31 Typical High $75.86 | Facility | None | $34.67 | $36.31 | $75.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $89.13 | Professional | None | $36.31 | $52.48 | $89.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $53.70 | Professional | 54 · Surgery only | $28.84 | $28.84 | $53.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Facility | None | $107.15 | $154.88 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $85.11 | Professional | None | $35.48 | $47.86 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $194.98 | Facility | None | $41.69 | $42.66 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
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 $27.54 Median $44.67 Typical High $74.13 | Professional | None | $27.54 | $44.67 | $74.13 |
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 $21.38 Median $22.91 Typical High $38.90 | Professional | 52 · Reduced service | $21.38 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $15.49 | Professional | 53 · Discontinued | $8.71 | $9.12 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $11.48 | Professional | 55 · Aftercare only | $6.46 | $6.92 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $7.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.68 Typical High $9.12 | Professional | 55 · Aftercare only | $3.98 | $4.68 | $9.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $43.65 Median $91.20 Typical High $114.82 | Professional | 63 · Small infant | $43.65 | $91.20 | $114.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $32.36 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $28.84 | $32.36 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $38.90 | Professional | 52 · Reduced service | $21.38 | $21.38 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $15.49 | Professional | 53 · Discontinued | $8.71 | $8.71 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $11.48 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $7.76 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $7.59 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.90 Median $30.90 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $30.90 | $30.90 | $57.54 |
Where Idaho sits
The same service costs 3.5 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· 13th of 51
$53.70
AK $120NJ $34.67
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.