How much rates vary
Facilitymedian $191 · 10th to 90th $52 to $603Professionalmedian $58 · 10th to 90th $41 to $110
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 $53.70 Median $102.33 Typical High $5,495.41 | Facility | None | $53.70 | $102.33 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $87.10 | Professional | None | $36.31 | $53.70 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $40.74 Typical High $64.57 | Professional | 54 · Surgery only | $33.88 | $40.74 | $64.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $58.88 Median $257.04 Typical High $602.56 | Facility | None | $58.88 | $257.04 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $120.23 | Professional | None | $45.71 | $75.86 | $120.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $45.71 Typical High $112.20 | Professional | 54 · Surgery only | $40.74 | $45.71 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $89.13 | Professional | None | $41.69 | $54.95 | $89.13 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $87.10 Typical High $1,412.54 | Facility | None | $45.71 | $87.10 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $109.65 | Professional | None | $39.81 | $57.54 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $64.57 | Professional | 54 · Surgery only | $33.88 | $33.88 | $64.57 |
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 $38.90 Median $40.74 Typical High $95.50 | Facility | None | $38.90 | $40.74 | $95.50 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $112.20 | Professional | None | $40.74 | $66.07 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $67.61 | Professional | 54 · Surgery only | $35.48 | $35.48 | $67.61 |
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 $45.71 Median $60.26 Typical High $109.65 | Professional | None | $45.71 | $60.26 | $109.65 |
Select Health Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $169.82 | Facility | None | $52.48 | $53.70 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
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 $33.11 Median $56.23 Typical High $91.20 | Professional | None | $33.11 | $56.23 | $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 $22.91 Median $26.92 Typical High $43.65 | Professional | 52 · Reduced service | $22.91 | $26.92 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.72 Typical High $17.38 | Professional | 53 · Discontinued | $9.12 | $10.72 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.13 Typical High $12.88 | Professional | 55 · Aftercare only | $6.76 | $8.13 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.37 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.57 | $5.37 | $8.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.13 Typical High $10.00 | Professional | 55 · Aftercare only | $4.57 | $5.13 | $10.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $52.48 Median $117.49 Typical High $144.54 | Professional | 63 · Small infant | $52.48 | $117.49 | $144.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.90 Median $36.31 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $30.90 | $36.31 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $43.65 | Professional | 52 · Reduced service | $22.91 | $22.91 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $17.38 | Professional | 53 · Discontinued | $9.12 | $9.12 | $17.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $12.88 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $8.71 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $9.77 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $38.02 | $38.02 | $72.44 |
Where Idaho sits
The same service costs 3.5 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· 15th of 51
$64.57
AK $151KY $42.66
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.