How much rates vary
Facilitymedian $170 · 10th to 90th $74 to $603Professionalmedian $93 · 10th to 90th $69 to $129
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 $91.20 Median $107.15 Typical High $4,466.84 | Facility | None | $91.20 | $107.15 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $107.15 | Professional | None | $64.57 | $83.18 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $70.79 Median $288.40 Typical High $602.56 | Facility | None | $70.79 | $288.40 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $141.25 | Professional | None | $85.11 | $104.71 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $102.33 | Professional | None | $67.61 | $85.11 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $104.71 Typical High $562.34 | Facility | None | $51.29 | $104.71 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $128.82 | Professional | None | $50.12 | $95.50 | $128.82 |
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 $75.86 Median $79.43 Typical High $112.20 | Facility | None | $75.86 | $79.43 | $112.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $128.82 | Professional | None | $79.43 | $93.33 | $128.82 |
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 $85.11 Median $104.71 Typical High $128.82 | Professional | None | $85.11 | $104.71 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $194.98 | Facility | None | $61.66 | $63.10 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | None | $61.66 | $61.66 | $87.10 |
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 $57.54 Median $81.28 Typical High $117.49 | Professional | None | $57.54 | $81.28 | $117.49 |
19 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 $41.69 Median $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $16.60 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | 54 · Surgery only | $61.66 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $70.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $91.20 Typical High $120.23 | Professional | 54 · Surgery only | $77.62 | $91.20 | $120.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $8.51 | $10.23 | $14.45 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | 63 · Small infant | $102.33 | $123.03 | $147.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $72.44 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $60.26 | $72.44 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $41.69 | $41.69 | $51.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $16.60 | $16.60 | $20.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | 54 · Surgery only | $61.66 | $61.66 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $70.79 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | 54 · Surgery only | $66.07 | $66.07 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $11.48 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $87.10 |
Where Idaho sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 9th of 51
$97.72
AK $224KY $53.70
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.