How much rates vary
Facilitymedian $562 · 10th to 90th $117 to $4,677Professionalmedian $182 · 10th to 90th $132 to $309
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 $173.78 Median $295.12 Typical High $5,495.41 | Facility | None | $173.78 | $295.12 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $245.47 | Professional | None | $97.72 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $186.21 | Professional | 54 · Surgery only | $109.65 | $114.82 | $186.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $1,258.93 Typical High $4,786.30 | Facility | None | $125.89 | $1,258.93 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $338.84 | Professional | None | $141.25 | $239.88 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $144.54 Typical High $316.23 | Professional | 54 · Surgery only | $134.90 | $144.54 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $158.49 | Facility | None | $104.71 | $117.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $251.19 | Professional | None | $131.83 | $177.83 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $1,621.81 Typical High $4,466.84 | Facility | None | $144.54 | $1,621.81 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $309.03 | Professional | None | $138.04 | $181.97 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $186.21 | Professional | 54 · Surgery only | $109.65 | $109.65 | $186.21 |
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 $134.90 Median $141.25 Typical High $269.15 | Facility | None | $134.90 | $141.25 | $269.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $316.23 | Professional | None | $141.25 | $186.21 | $316.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $190.55 | Professional | 54 · Surgery only | $112.20 | $112.20 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $309.03 | Professional | None | $141.25 | $186.21 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $707.95 | Facility | None | $147.91 | $151.36 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $263.03 | Professional | None | $104.71 | $169.82 | $263.03 |
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 $72.44 Median $77.62 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $77.62 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.90 Typical High $48.98 | Professional | 53 · Discontinued | $28.84 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $15.49 | $24.55 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $24.55 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $186.21 Median $323.59 Typical High $389.05 | Professional | 63 · Small infant | $186.21 | $323.59 | $389.05 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $107.15 | $165.96 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $72.44 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $48.98 | Professional | 53 · Discontinued | $28.84 | $28.84 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $26.92 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $204.17 |
Where Idaho sits
The same service costs 3.2 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· 15th of 51
$186
AK $407NJ $129
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.