How much rates vary
Facilitymedian $151 · 10th to 90th $40 to $776Professionalmedian $74 · 10th to 90th $50 to $117
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 $74.13 Median $109.65 Typical High $5,495.41 | Facility | None | $74.13 | $109.65 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $74.13 Typical High $109.65 | Professional | None | $44.67 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $54.95 Typical High $81.28 | Professional | 54 · Surgery only | $33.11 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.96 Typical High $16.22 | Professional | 55 · Aftercare only | $6.76 | $10.96 | $16.22 |
BCBS Idaho Setting Facility Modifier None Typical Low $39.81 Median $281.84 Typical High $776.25 | Facility | None | $39.81 | $281.84 | $776.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $117.49 | Professional | None | $57.54 | $83.18 | $117.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $107.15 | Professional | 54 · Surgery only | $51.29 | $61.66 | $107.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.76 Typical High $12.30 | Professional | 55 · Aftercare only | $5.75 | $6.76 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $39.81 Typical High $53.70 | Facility | None | $35.48 | $39.81 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $81.28 | Professional | None | $48.98 | $57.54 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $109.65 Typical High $1,412.54 | Facility | None | $51.29 | $109.65 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $128.82 | Professional | None | $50.12 | $85.11 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $54.95 Typical High $81.28 | Professional | 54 · Surgery only | $33.11 | $54.95 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.96 Typical High $16.22 | Professional | 55 · Aftercare only | $6.76 | $10.96 | $16.22 |
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 $61.66 Median $61.66 Typical High $109.65 | Facility | None | $61.66 | $61.66 | $109.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $138.04 | Professional | None | $61.66 | $79.43 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $83.18 | Professional | 54 · Surgery only | $56.23 | $56.23 | $83.18 |
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 $70.79 Median $85.11 Typical High $128.82 | Professional | None | $70.79 | $85.11 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $512.86 | Facility | None | $52.48 | $53.70 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $69.18 | Professional | None | $36.31 | $52.48 | $69.18 |
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 $39.81 Median $60.26 Typical High $100.00 | Professional | None | $39.81 | $60.26 | $100.00 |
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 $22.39 Median $37.15 Typical High $54.95 | Professional | 52 · Reduced service | $22.39 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.79 Typical High $21.88 | Professional | 53 · Discontinued | $8.91 | $14.79 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.41 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.47 | $7.41 | $10.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $60.26 Median $407.38 Typical High $1,148.15 | Facility | 50 · Both sides | $60.26 | $407.38 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $104.71 Typical High $177.83 | Professional | 50 · Both sides | $85.11 | $104.71 | $177.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $67.61 Median $112.20 Typical High $144.54 | Professional | 63 · Small infant | $67.61 | $112.20 | $144.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $47.86 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $39.81 | $47.86 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $37.15 Typical High $54.95 | Professional | 52 · Reduced service | $22.39 | $37.15 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.79 Typical High $21.88 | Professional | 53 · Discontinued | $8.91 | $14.79 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.41 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.47 | $7.41 | $10.96 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $120.23 Typical High $177.83 | Professional | 50 · Both sides | $120.23 | $120.23 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $12.02 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $60.26 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $89.13 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in Florida. 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
$74.13
AK $174FL $42.66
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.