How much rates vary
Facilitymedian $204 · 10th to 90th $78 to $776Professionalmedian $126 · 10th to 90th $83 to $219
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 $95.50 Median $165.96 Typical High $4,466.84 | Facility | None | $95.50 | $165.96 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $204.17 | Professional | None | $74.13 | $123.03 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $91.20 Typical High $154.88 | Professional | 54 · Surgery only | $56.23 | $91.20 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.20 Typical High $30.90 | Professional | 55 · Aftercare only | $11.22 | $18.20 | $30.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $363.08 Typical High $776.25 | Facility | None | $77.62 | $363.08 | $776.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $218.78 | Professional | None | $93.33 | $154.88 | $218.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $186.21 | Professional | 54 · Surgery only | $81.28 | $95.50 | $186.21 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $21.38 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $107.15 | Facility | None | $70.79 | $79.43 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $154.88 | Professional | None | $85.11 | $107.15 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $229.09 Typical High $870.96 | Facility | None | $85.11 | $229.09 | $870.96 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $141.25 Typical High $239.88 | Professional | None | $77.62 | $141.25 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $91.20 Typical High $154.88 | Professional | 54 · Surgery only | $56.23 | $91.20 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.20 Typical High $30.90 | Professional | 55 · Aftercare only | $11.22 | $18.20 | $30.90 |
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 $97.72 Median $97.72 Typical High $204.17 | Facility | None | $97.72 | $97.72 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $257.04 | Professional | None | $97.72 | $131.83 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $154.88 | Professional | 54 · Surgery only | $91.20 | $91.20 | $154.88 |
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 $117.49 Median $144.54 Typical High $239.88 | Professional | None | $117.49 | $144.54 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $426.58 | Facility | None | $97.72 | $97.72 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $125.89 | Professional | None | $58.88 | $91.20 | $125.89 |
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 $66.07 Median $102.33 Typical High $169.82 | Professional | None | $66.07 | $102.33 | $169.82 |
14 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 $37.15 Median $61.66 Typical High $102.33 | Professional | 52 · Reduced service | $37.15 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $24.55 Typical High $40.74 | Professional | 53 · Discontinued | $15.14 | $24.55 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.30 Typical High $20.42 | Professional | 56 · Pre-op care only | $7.41 | $12.30 | $20.42 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $524.81 Typical High $1,348.96 | Facility | 50 · Both sides | $117.49 | $524.81 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $165.96 Typical High $331.13 | Professional | 50 · Both sides | $134.90 | $165.96 | $331.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $109.65 Median $223.87 Typical High $275.42 | Professional | 63 · Small infant | $109.65 | $223.87 | $275.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $66.07 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $338.84 Typical High $691.83 | Professional | 50 · Both sides | $83.18 | $338.84 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $61.66 Typical High $102.33 | Professional | 52 · Reduced service | $37.15 | $61.66 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $24.55 Typical High $40.74 | Professional | 53 · Discontinued | $15.14 | $24.55 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.30 Typical High $20.42 | Professional | 56 · Pre-op care only | $7.41 | $12.30 | $20.42 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 50 · Both sides | $194.98 | $194.98 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $97.72 | $97.72 | $165.96 |
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· 11th of 51
$129
AK $275KY $74.13
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.