How much rates vary
Facilitymedian $407 · 10th to 90th $123 to $1,413Professionalmedian $178 · 10th to 90th $102 to $417
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 $117.49 Median $1,412.54 Typical High $7,079.46 | Facility | None | $117.49 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $416.87 | Professional | None | $91.20 | $173.78 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $114.82 Typical High $309.03 | Professional | 54 · Surgery only | $79.43 | $114.82 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $61.66 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $61.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $645.65 | Facility | None | $309.03 | $501.19 | $645.65 |
BCBS Idaho Setting Professional Modifier None Typical Low $117.49 Median $281.84 Typical High $398.11 | Professional | None | $117.49 | $281.84 | $398.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $120.23 Typical High $354.81 | Professional | 54 · Surgery only | $102.33 | $120.23 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $11.22 | $33.88 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $309.03 | Professional | None | $104.71 | $190.55 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $416.87 Typical High $4,466.84 | Facility | None | $151.36 | $416.87 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $436.52 | Professional | None | $102.33 | $177.83 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $309.03 | Professional | 54 · Surgery only | $114.82 | $114.82 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $61.66 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $61.66 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $107.15 | Professional | None | $33.11 | $33.11 | $107.15 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $363.08 | Facility | None | $123.03 | $123.03 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $457.09 | Professional | None | $123.03 | $218.78 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $389.05 | Professional | None | $138.04 | $186.21 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $398.11 | Facility | None | $173.78 | $177.83 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $269.15 | Professional | None | $112.20 | $173.78 | $269.15 |
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 $81.28 Median $173.78 Typical High $338.84 | Professional | None | $81.28 | $173.78 | $338.84 |
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 $53.70 Median $75.86 Typical High $208.93 | Professional | 52 · Reduced service | $53.70 | $75.86 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $83.18 | Professional | 53 · Discontinued | $21.38 | $30.90 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.14 Typical High $41.69 | Professional | 56 · Pre-op care only | $10.72 | $15.14 | $41.69 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $512.86 Median $794.33 Typical High $977.24 | Facility | 50 · Both sides | $512.86 | $794.33 | $977.24 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $501.19 Typical High $616.60 | Professional | 50 · Both sides | $173.78 | $501.19 | $616.60 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $141.25 Median $407.38 Typical High $478.63 | Professional | 63 · Small infant | $141.25 | $407.38 | $478.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $89.13 | $234.42 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $208.93 | Professional | 52 · Reduced service | $75.86 | $75.86 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $83.18 | Professional | 53 · Discontinued | $30.90 | $30.90 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $41.69 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $41.69 |
Where Idaho sits
The same service costs 3.8 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· 26th of 51
$178
AK $363VA $95.50
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.