How much rates vary
Facilitymedian $229 · 10th to 90th $69 to $603Professionalmedian $87 · 10th to 90th $63 to $155
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 $70.79 Median $70.79 Typical High $125.89 | Facility | None | $70.79 | $70.79 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $114.82 | Professional | None | $45.71 | $69.18 | $114.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $316.23 Typical High $602.56 | Facility | None | $61.66 | $316.23 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $190.55 | Professional | None | $69.18 | $117.49 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $117.49 | Professional | None | $63.10 | $81.28 | $117.49 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $165.96 | Facility | None | $52.48 | $83.18 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $151.36 | Professional | None | $69.18 | $87.10 | $151.36 |
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 $66.07 Median $69.18 Typical High $147.91 | Facility | None | $66.07 | $69.18 | $147.91 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $173.78 | Professional | None | $69.18 | $104.71 | $173.78 |
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 $69.18 Median $91.20 Typical High $151.36 | Professional | None | $69.18 | $91.20 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $194.98 | Facility | None | $83.18 | $85.11 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | None | $83.18 | $83.18 | $102.33 |
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 $50.12 Median $75.86 Typical High $117.49 | Professional | None | $50.12 | $75.86 | $117.49 |
15 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 $34.67 Median $36.31 Typical High $57.54 | Professional | 52 · Reduced service | $34.67 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $22.91 | Professional | 53 · Discontinued | $13.80 | $14.45 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $17.38 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $11.48 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $77.62 Typical High $144.54 | Professional | 54 · Surgery only | $63.10 | $77.62 | $144.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $13.49 Typical High $19.50 | Professional | 55 · Aftercare only | $7.24 | $13.49 | $19.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $91.20 Median $100.00 Typical High $204.17 | Professional | 63 · Small infant | $91.20 | $100.00 | $204.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $58.88 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $52.48 | $58.88 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $57.54 | Professional | 52 · Reduced service | $34.67 | $34.67 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $22.91 | Professional | 53 · Discontinued | $13.80 | $13.80 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $17.38 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $11.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $95.50 | Professional | 54 · Surgery only | $53.70 | $53.70 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $13.49 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $102.33 |
Where Idaho sits
The same service costs 3.3 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· 13th of 51
$91.20
AK $191NJ $57.54
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.