How much rates vary
Facilitymedian $182 · 10th to 90th $68 to $891Professionalmedian $132 · 10th to 90th $89 to $186
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $177.83 | Professional | None | $74.13 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $131.83 | Professional | 54 · Surgery only | $61.66 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $26.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $229.09 Typical High $891.25 | Facility | None | $67.61 | $229.09 | $891.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $194.98 | Professional | None | $104.71 | $144.54 | $194.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $112.20 Typical High $181.97 | Professional | 54 · Surgery only | $93.33 | $112.20 | $181.97 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.80 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $13.80 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $93.33 | Facility | None | $60.26 | $67.61 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $134.90 | Professional | None | $87.10 | $102.33 | $134.90 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $177.83 Typical High $5,495.41 | Facility | None | $83.18 | $177.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $190.55 | Professional | None | $91.20 | $154.88 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $131.83 | Professional | 54 · Surgery only | $61.66 | $100.00 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $26.30 |
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 $112.20 Median $112.20 Typical High $181.97 | Facility | None | $112.20 | $112.20 | $181.97 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $229.09 | Professional | None | $112.20 | $144.54 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $100.00 | $100.00 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $977.24 | Facility | None | $501.19 | $724.44 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $208.93 | Professional | None | $131.83 | $154.88 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $91.20 | Facility | None | $87.10 | $87.10 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $112.20 | Professional | None | $63.10 | $87.10 | $112.20 |
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 $72.44 Median $100.00 Typical High $154.88 | Professional | None | $72.44 | $100.00 | $154.88 |
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 $40.74 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $40.74 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $16.60 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $17.78 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $100.00 Median $346.74 Typical High $1,348.96 | Facility | 50 · Both sides | $100.00 | $346.74 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $251.19 Typical High $302.00 | Professional | 50 · Both sides | $162.18 | $251.19 | $302.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $125.89 Median $190.55 Typical High $245.47 | Professional | 63 · Small infant | $125.89 | $190.55 | $245.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $85.11 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $72.44 | $85.11 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $40.74 | $66.07 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $16.60 | $26.30 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $17.78 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 50 · Both sides | $213.80 | $213.80 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $19.05 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $144.54 |
Where Idaho sits
The same service costs 3.8 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
$132
AK $263KY $69.18
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.