How much rates vary
Facilitymedian $251 · 10th to 90th $55 to $871Professionalmedian $93 · 10th to 90th $63 to $141
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 $72.44 Median $114.82 Typical High $1,412.54 | Facility | None | $72.44 | $114.82 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $131.83 | Professional | None | $57.54 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $69.18 Typical High $100.00 | Professional | 54 · Surgery only | $42.66 | $69.18 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $758.58 | Facility | None | $181.97 | $257.04 | $758.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $144.54 | Professional | None | $74.13 | $102.33 | $144.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $64.57 | $102.33 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $47.86 Typical High $64.57 | Facility | None | $42.66 | $47.86 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $100.00 | Professional | None | $61.66 | $72.44 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $257.04 Typical High $1,288.25 | Facility | None | $83.18 | $257.04 | $1,288.25 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $154.88 | Professional | None | $54.95 | $95.50 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $69.18 Typical High $100.00 | Professional | 54 · Surgery only | $42.66 | $69.18 | $100.00 |
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 $77.62 Median $131.83 Typical High $251.19 | Facility | None | $77.62 | $131.83 | $251.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $165.96 | Professional | None | $77.62 | $97.72 | $165.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | 54 · Surgery only | $67.61 | $67.61 | $97.72 |
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 $91.20 Median $107.15 Typical High $154.88 | Professional | None | $91.20 | $107.15 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $64.57 Typical High $524.81 | Facility | None | $63.10 | $64.57 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $83.18 | Professional | None | $43.65 | $63.10 | $83.18 |
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 $50.12 Median $77.62 Typical High $123.03 | Professional | None | $50.12 | $77.62 | $123.03 |
17 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 $46.77 Typical High $66.07 | Professional | 52 · Reduced service | $28.18 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $18.62 Typical High $26.30 | Professional | 53 · Discontinued | $11.48 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.80 Typical High $19.95 | Professional | 55 · Aftercare only | $8.51 | $13.80 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.33 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.75 | $9.33 | $13.18 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $263.03 Median $446.68 Typical High $1,148.15 | Facility | 50 · Both sides | $263.03 | $446.68 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $128.82 Typical High $213.80 | Professional | 50 · Both sides | $107.15 | $128.82 | $213.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $7.08 | $10.23 | $14.45 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $85.11 Median $114.82 Typical High $169.82 | Professional | 63 · Small infant | $85.11 | $114.82 | $169.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $83.18 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $51.29 | $83.18 | $100.00 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $46.77 Median $154.88 Typical High $446.68 | Professional | 50 · Both sides | $46.77 | $154.88 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $46.77 Typical High $66.07 | Professional | 52 · Reduced service | $31.62 | $46.77 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $18.62 Typical High $26.30 | Professional | 53 · Discontinued | $12.59 | $18.62 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.80 Typical High $19.95 | Professional | 55 · Aftercare only | $8.51 | $13.80 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.33 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.75 | $9.33 | $13.18 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | 50 · Both sides | $144.54 | $144.54 | $208.93 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $13.80 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $104.71 |
Where Idaho sits
The same service costs 4.2 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· 11th of 51
$93.33
AK $224FL $53.70
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.