How much rates vary
Facilitymedian $234 · 10th to 90th $68 to $603Professionalmedian $76 · 10th to 90th $50 to $166
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 $67.61 Median $162.18 Typical High $5,495.41 | Facility | None | $67.61 | $162.18 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $141.25 | Professional | None | $46.77 | $67.61 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $64.57 Typical High $102.33 | Professional | 54 · Surgery only | $42.66 | $64.57 | $102.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $104.71 Median $281.84 Typical High $602.56 | Facility | None | $104.71 | $281.84 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $57.54 Median $131.83 Typical High $190.55 | Professional | None | $57.54 | $131.83 | $190.55 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $64.57 Typical High $177.83 | Professional | 54 · Surgery only | $56.23 | $64.57 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $138.04 | Professional | None | $48.98 | $77.62 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $162.18 Typical High $524.81 | Facility | None | $38.02 | $162.18 | $524.81 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $165.96 | Professional | None | $56.23 | $70.79 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $102.33 | Professional | 54 · Surgery only | $42.66 | $42.66 | $102.33 |
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 $56.23 Median $58.88 Typical High $147.91 | Facility | None | $56.23 | $58.88 | $147.91 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $173.78 | Professional | None | $58.88 | $104.71 | $173.78 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $102.33 | Professional | 54 · Surgery only | $44.67 | $44.67 | $102.33 |
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 $57.54 Median $75.86 Typical High $165.96 | Professional | None | $57.54 | $75.86 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $281.84 | Facility | None | $83.18 | $85.11 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $107.15 | Professional | None | $83.18 | $83.18 | $107.15 |
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 $40.74 Median $70.79 Typical High $134.90 | Professional | None | $40.74 | $70.79 | $134.90 |
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 $28.18 Median $42.66 Typical High $67.61 | Professional | 52 · Reduced service | $28.18 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.98 Typical High $26.92 | Professional | 53 · Discontinued | $11.22 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.88 Typical High $20.42 | Professional | 55 · Aftercare only | $8.51 | $12.88 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.51 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.62 | $8.51 | $13.49 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.08 Typical High $18.20 | Professional | 55 · Aftercare only | $5.75 | $7.08 | $18.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $70.79 Median $89.13 Typical High $234.42 | Professional | 63 · Small infant | $70.79 | $89.13 | $234.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $52.48 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $44.67 | $52.48 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $67.61 | Professional | 52 · Reduced service | $28.18 | $28.18 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $26.92 | Professional | 53 · Discontinued | $11.22 | $11.22 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $20.42 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $13.49 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $14.79 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $47.86 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $47.86 | $47.86 | $109.65 |
Where Idaho sits
The same service costs 3.7 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· 7th of 51
$102
AK $178KY $47.86
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.