How much rates vary
Facilitymedian $141 · 10th to 90th $27 to $501Professionalmedian $33 · 10th to 90th $25 to $60
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $47.86 | Professional | None | $26.92 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $22.39 Typical High $36.31 | Professional | 54 · Surgery only | $19.95 | $22.39 | $36.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $48.98 Median $81.28 Typical High $229.09 | Facility | None | $48.98 | $81.28 | $229.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $66.07 | Professional | None | $25.12 | $32.36 | $66.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $41.69 Typical High $61.66 | Professional | 54 · Surgery only | $25.70 | $41.69 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $31.62 Typical High $57.54 | Professional | None | $22.91 | $31.62 | $57.54 |
Moda Health Setting Facility Modifier None Typical Low $13.80 Median $38.02 Typical High $4,466.84 | Facility | None | $13.80 | $38.02 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $58.88 | Professional | None | $23.44 | $32.36 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $36.31 | Professional | 54 · Surgery only | $19.95 | $19.95 | $36.31 |
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 $23.44 Median $24.55 Typical High $52.48 | Facility | None | $23.44 | $24.55 | $52.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $61.66 | Professional | None | $24.55 | $28.84 | $61.66 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $36.31 | Professional | 54 · Surgery only | $19.95 | $19.95 | $36.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.12 Median $33.11 Typical High $58.88 | Professional | None | $25.12 | $33.11 | $58.88 |
Select Health Setting Facility Modifier None Typical Low $29.51 Median $30.20 Typical High $169.82 | Facility | None | $29.51 | $30.20 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $38.02 | Professional | None | $29.51 | $29.51 | $38.02 |
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 $19.05 Median $33.11 Typical High $72.44 | Professional | None | $19.05 | $33.11 | $72.44 |
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 $13.49 Median $14.79 Typical High $23.99 | Professional | 52 · Reduced service | $13.49 | $14.79 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.89 Typical High $9.55 | Professional | 53 · Discontinued | $5.37 | $5.89 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.47 Typical High $7.24 | Professional | 55 · Aftercare only | $3.98 | $4.47 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.95 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.69 | $2.95 | $4.79 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $3.09 Typical High $5.75 | Professional | 55 · Aftercare only | $2.57 | $3.09 | $5.75 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $32.36 Median $54.95 Typical High $83.18 | Professional | 63 · Small infant | $32.36 | $54.95 | $83.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $18.62 Median $22.91 Typical High $46.77 | Professional | 78 · Unplanned return to OR | $18.62 | $22.91 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $13.49 Typical High $23.99 | Professional | 52 · Reduced service | $13.49 | $13.49 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $9.55 | Professional | 53 · Discontinued | $5.37 | $5.37 | $9.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $7.24 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $7.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $4.79 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $5.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $21.38 Median $21.38 Typical High $38.90 | Professional | 78 · Unplanned return to OR | $21.38 | $21.38 | $38.90 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 16th of 51
$43.65
AK $85.11HI $21.88
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.