How much rates vary
Facilitymedian $380 · 10th to 90th $145 to $1,047Professionalmedian $186 · 10th to 90th $117 to $363
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 $173.78 Median $338.84 Typical High $4,466.84 | Facility | None | $173.78 | $338.84 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $338.84 | Professional | None | $104.71 | $194.98 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $128.82 Typical High $251.19 | Professional | 54 · Surgery only | $77.62 | $128.82 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $50.12 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $50.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $912.01 | Facility | None | $436.52 | $645.65 | $912.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $371.54 | Professional | None | $138.04 | $263.03 | $371.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $120.23 | $263.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $13.49 | $30.90 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $263.03 | Professional | None | $117.49 | $158.49 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $338.84 Typical High $1,949.84 | Facility | None | $162.18 | $338.84 | $1,949.84 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $380.19 | Professional | None | $117.49 | $199.53 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $128.82 Typical High $251.19 | Professional | 54 · Surgery only | $77.62 | $128.82 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $50.12 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $50.12 |
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 $144.54 Median $144.54 Typical High $338.84 | Facility | None | $144.54 | $144.54 | $338.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $436.52 | Professional | None | $144.54 | $186.21 | $436.52 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $257.04 | Professional | 54 · Surgery only | $128.82 | $128.82 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $389.05 | Professional | None | $165.96 | $204.17 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $501.19 | Facility | None | $162.18 | $165.96 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $208.93 | Professional | None | $85.11 | $162.18 | $208.93 |
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 $91.20 Median $173.78 Typical High $316.23 | Professional | None | $91.20 | $173.78 | $316.23 |
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 $52.48 Median $85.11 Typical High $169.82 | Professional | 52 · Reduced service | $52.48 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $34.67 Typical High $67.61 | Professional | 53 · Discontinued | $20.89 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $17.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.47 | $17.38 | $33.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $630.96 Median $954.99 Typical High $1,348.96 | Facility | 50 · Both sides | $630.96 | $954.99 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $245.47 Typical High $524.81 | Professional | 50 · Both sides | $208.93 | $245.47 | $524.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $162.18 Median $354.81 Typical High $446.68 | Professional | 63 · Small infant | $162.18 | $354.81 | $446.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $114.82 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $95.50 | $114.82 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $85.11 Typical High $169.82 | Professional | 52 · Reduced service | $52.48 | $85.11 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $34.67 Typical High $67.61 | Professional | 53 · Discontinued | $20.89 | $34.67 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $17.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.47 | $17.38 | $33.88 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $275.42 Typical High $549.54 | Professional | 50 · Both sides | $275.42 | $275.42 | $549.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $275.42 |
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· 13th of 51
$200
AK $417VA $107
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.