How much rates vary
Facilitymedian $62 · 10th to 90th $35 to $135Professionalmedian $50 · 10th to 90th $35 to $79
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $56.23 Median $93.33 Typical High $5,495.41 | Facility | None | $56.23 | $93.33 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $79.43 | Professional | None | $30.20 | $47.86 | $79.43 |
BCBS Idaho Setting Facility Modifier None Typical Low $38.90 Median $60.26 Typical High $97.72 | Facility | None | $38.90 | $60.26 | $97.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $81.28 | Professional | None | $36.31 | $53.70 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $60.26 | Professional | None | $34.67 | $44.67 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $56.23 Typical High $4,466.84 | Facility | None | $28.18 | $56.23 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $79.43 | Professional | None | $33.88 | $56.23 | $79.43 |
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 $39.81 Median $39.81 Typical High $75.86 | Facility | None | $39.81 | $39.81 | $75.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $95.50 | Professional | None | $39.81 | $51.29 | $95.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $97.72 | Facility | None | $47.86 | $69.18 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $79.43 | Professional | None | $41.69 | $56.23 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $36.31 | Facility | None | $35.48 | $35.48 | $36.31 |
Select Health Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $47.86 | Professional | None | $24.55 | $35.48 | $47.86 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $26.92 Median $42.66 Typical High $75.86 | Professional | None | $26.92 | $42.66 | $75.86 |
7 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $61.66 Typical High $74.13 | Professional | 54 · Surgery only | $33.11 | $61.66 | $74.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.47 Typical High $7.94 | Professional | 55 · Aftercare only | $3.63 | $4.47 | $7.94 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $43.65 Median $51.29 Typical High $97.72 | Professional | 63 · Small infant | $43.65 | $51.29 | $97.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.70 Median $30.20 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $25.70 | $30.20 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $56.23 Typical High $58.88 | Professional | 54 · Surgery only | $35.48 | $56.23 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.13 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.13 | $8.13 | $8.32 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $60.26 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $38.02 | $60.26 | $63.10 |
Where Idaho sits
The same service costs 7.1 times more in New York than in Maryland. 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· 10th of 51
$50.12
NY $182MD $25.70
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.