How much rates vary
Facilitymedian $355 · 10th to 90th $105 to $2,291Professionalmedian $138 · 10th to 90th $65 to $347
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 $79.43 Median $288.40 Typical High $4,466.84 | Facility | None | $79.43 | $288.40 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $134.90 Typical High $346.74 | Professional | None | $51.29 | $134.90 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $77.62 Typical High $263.03 | Professional | 54 · Surgery only | $54.95 | $77.62 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.85 Typical High $52.48 | Professional | 55 · Aftercare only | $10.96 | $15.85 | $52.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $245.47 Median $426.58 Typical High $575.44 | Facility | None | $245.47 | $426.58 | $575.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $331.13 | Professional | None | $79.43 | $234.42 | $331.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $81.28 Typical High $302.00 | Professional | 54 · Surgery only | $69.18 | $81.28 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $17.38 Typical High $33.88 | Professional | 55 · Aftercare only | $7.76 | $17.38 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $154.88 Typical High $257.04 | Professional | None | $70.79 | $154.88 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | None | $794.33 | $794.33 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $363.08 Typical High $4,265.80 | Facility | None | $104.71 | $363.08 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $346.74 | Professional | None | $61.66 | $147.91 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $263.03 | Professional | 54 · Surgery only | $77.62 | $77.62 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $52.48 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $52.48 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $89.13 | Professional | None | $33.11 | $33.11 | $89.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $302.00 | Facility | None | $83.18 | $83.18 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $389.05 | Professional | None | $83.18 | $173.78 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $323.59 | Professional | None | $93.33 | $125.89 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $398.11 | Facility | None | $144.54 | $147.91 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $223.87 | Professional | None | $77.62 | $144.54 | $223.87 |
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 $56.23 Median $138.04 Typical High $275.42 | Professional | None | $56.23 | $138.04 | $275.42 |
10 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 $52.48 Typical High $173.78 | Professional | 52 · Reduced service | $37.15 | $52.48 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $69.18 | Professional | 53 · Discontinued | $14.79 | $20.89 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $34.67 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $34.67 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $363.08 Median $676.08 Typical High $870.96 | Facility | 50 · Both sides | $363.08 | $676.08 | $870.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $446.68 | Professional | 50 · Both sides | $117.49 | $138.04 | $446.68 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $93.33 Median $112.20 Typical High $398.11 | Professional | 63 · Small infant | $93.33 | $112.20 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $63.10 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $53.70 | $63.10 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $173.78 | Professional | 52 · Reduced service | $52.48 | $52.48 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $69.18 | Professional | 53 · Discontinued | $20.89 | $20.89 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $34.67 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 19th of 51
$155
AK $257VA $66.07
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.