How much rates vary
Facilitymedian $47 · 10th to 90th $3 to $501Professionalmedian $6 · 10th to 90th $3 to $13
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 $3.31 Median $12.88 Typical High $7,079.46 | Facility | None | $3.31 | $12.88 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $6.31 Typical High $10.72 | Professional | None | $2.95 | $6.31 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $4.57 Typical High $7.76 | Professional | 54 · Surgery only | $2.45 | $4.57 | $7.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $6.92 Median $30.90 Typical High $177.83 | Facility | None | $6.92 | $30.90 | $177.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.09 Median $8.71 Typical High $13.49 | Professional | None | $3.09 | $8.71 | $13.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2.88 Median $3.47 Typical High $12.30 | Professional | 54 · Surgery only | $2.88 | $3.47 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $5.62 Typical High $10.23 | Professional | None | $3.02 | $5.62 | $10.23 |
Moda Health Setting Facility Modifier None Typical Low $3.31 Median $9.55 Typical High $4,466.84 | Facility | None | $3.31 | $9.55 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $2.75 Median $5.75 Typical High $12.88 | Professional | None | $2.75 | $5.75 | $12.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.45 Typical High $7.76 | Professional | 54 · Surgery only | $2.45 | $2.45 | $7.76 |
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 $2.82 Median $2.95 Typical High $10.72 | Facility | None | $2.82 | $2.95 | $10.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.95 Median $3.55 Typical High $12.59 | Professional | None | $2.95 | $3.55 | $12.59 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2.51 Median $2.51 Typical High $7.94 | Professional | 54 · Surgery only | $2.51 | $2.51 | $7.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.09 Median $4.27 Typical High $12.88 | Professional | None | $3.09 | $4.27 | $12.88 |
Select Health Setting Facility Modifier None Typical Low $5.89 Median $6.03 Typical High $67.61 | Facility | None | $5.89 | $6.03 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | None | $5.89 | $5.89 | $8.51 |
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 $2.51 Median $6.46 Typical High $12.59 | Professional | None | $2.51 | $6.46 | $12.59 |
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 $1.66 Median $3.09 Typical High $5.13 | Professional | 52 · Reduced service | $1.66 | $3.09 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $1.23 Typical High $2.04 | Professional | 53 · Discontinued | $0.66 | $1.23 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.91 Typical High $1.55 | Professional | 55 · Aftercare only | $0.49 | $0.91 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.62 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.33 | $0.62 | $1.02 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.36 Typical High $1.41 | Professional | 55 · Aftercare only | $0.31 | $0.36 | $1.41 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3.80 Median $4.47 Typical High $14.13 | Professional | 63 · Small infant | $3.80 | $4.47 | $14.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.24 Median $2.51 Typical High $9.77 | Professional | 78 · Unplanned return to OR | $2.24 | $2.51 | $9.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $1.66 Typical High $5.13 | Professional | 52 · Reduced service | $1.66 | $1.66 | $5.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.66 Typical High $2.04 | Professional | 53 · Discontinued | $0.66 | $0.66 | $2.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $1.55 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $1.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.89 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.33 | $0.89 | $1.02 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $1.12 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.69 Median $2.69 Typical High $8.51 | Professional | 78 · Unplanned return to OR | $2.69 | $2.69 | $8.51 |
Where Idaho sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$7.41
AK $12.88NE $4.37
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.