How much rates vary
Facilitymedian $166 · 10th to 90th $37 to $661Professionalmedian $46 · 10th to 90th $35 to $63
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 $30.90 Median $38.90 Typical High $50.12 | Professional | None | $30.90 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | 54 · Surgery only | $29.51 | $29.51 | $37.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $69.18 Median $134.90 Typical High $549.54 | Facility | None | $69.18 | $134.90 | $549.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $69.18 | Professional | None | $38.02 | $47.86 | $69.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $41.69 Typical High $61.66 | Professional | 54 · Surgery only | $35.48 | $41.69 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $52.48 | Professional | None | $33.88 | $39.81 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $50.12 Typical High $5,495.41 | Facility | None | $30.90 | $50.12 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $63.10 | Professional | None | $36.31 | $47.86 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | 54 · Surgery only | $29.51 | $29.51 | $37.15 |
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 $34.67 Median $37.15 Typical High $56.23 | Facility | None | $34.67 | $37.15 | $56.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $66.07 | Professional | None | $37.15 | $43.65 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $29.51 Typical High $38.90 | Professional | 54 · Surgery only | $29.51 | $29.51 | $38.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $63.10 | Professional | None | $38.02 | $47.86 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $32.36 | Facility | None | $31.62 | $31.62 | $32.36 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | None | $31.62 | $31.62 | $41.69 |
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 $26.92 Median $38.90 Typical High $56.23 | Professional | None | $26.92 | $38.90 | $56.23 |
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 $19.50 Median $19.50 Typical High $25.12 | Professional | 52 · Reduced service | $19.50 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $10.00 | Professional | 53 · Discontinued | $7.76 | $7.76 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $7.59 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $5.01 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.50 Typical High $6.76 | Professional | 55 · Aftercare only | $3.98 | $5.50 | $6.76 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $47.86 Median $53.70 Typical High $70.79 | Professional | 63 · Small infant | $47.86 | $53.70 | $70.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $33.11 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $26.92 | $33.11 | $42.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $25.12 | Professional | 52 · Reduced service | $19.50 | $19.50 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $10.00 | Professional | 53 · Discontinued | $7.76 | $7.76 | $10.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $7.59 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $7.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $5.01 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $5.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $31.62 | $31.62 | $41.69 |
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· 11th of 51
$45.71
AK $100NJ $28.84
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.