How much rates vary
Facilitymedian $302 · 10th to 90th $79 to $1,318Professionalmedian $107 · 10th to 90th $78 to $182
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 $75.86 Median $89.13 Typical High $141.25 | Professional | None | $75.86 | $89.13 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $66.07 Typical High $107.15 | Professional | 54 · Surgery only | $63.10 | $66.07 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $48.98 Median $467.74 Typical High $1,202.26 | Facility | None | $48.98 | $467.74 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $204.17 | Professional | None | $85.11 | $123.03 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $95.50 Typical High $173.78 | Professional | 54 · Surgery only | $75.86 | $95.50 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $147.91 | Professional | None | $77.62 | $102.33 | $147.91 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $4,466.84 | Facility | None | $85.11 | $125.89 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $181.97 | Professional | None | $79.43 | $107.15 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | 54 · Surgery only | $63.10 | $63.10 | $107.15 |
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 $77.62 Median $81.28 Typical High $162.18 | Facility | None | $77.62 | $81.28 | $162.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $190.55 | Professional | None | $81.28 | $112.20 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $112.20 | Professional | 54 · Surgery only | $66.07 | $66.07 | $112.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,318.26 | Facility | None | $524.81 | $891.25 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $181.97 | Professional | None | $85.11 | $109.65 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $151.36 | Facility | None | $89.13 | $91.20 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $120.23 | Professional | None | $89.13 | $89.13 | $120.23 |
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 $61.66 Median $109.65 Typical High $158.49 | Professional | None | $61.66 | $109.65 | $158.49 |
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 $42.66 Median $44.67 Typical High $70.79 | Professional | 52 · Reduced service | $42.66 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $28.18 | Professional | 53 · Discontinued | $16.98 | $17.78 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $21.38 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $14.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.77 Typical High $20.89 | Professional | 55 · Aftercare only | $8.71 | $9.77 | $20.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $102.33 Median $117.49 Typical High $251.19 | Professional | 63 · Small infant | $102.33 | $117.49 | $251.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $58.88 | $112.20 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $70.79 | Professional | 52 · Reduced service | $42.66 | $42.66 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $28.18 | Professional | 53 · Discontinued | $16.98 | $16.98 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $21.38 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $14.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $15.85 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $120.23 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in New York. 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· 14th of 51
$117
AK $245NY $77.62
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.