How much rates vary
Facilitymedian $191 · 10th to 90th $89 to $692Professionalmedian $138 · 10th to 90th $93 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 Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $190.55 | Professional | None | $87.10 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $12.88 | $20.42 | $28.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $89.13 Median $281.84 Typical High $812.83 | Facility | None | $89.13 | $281.84 | $812.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $223.87 | Professional | None | $114.82 | $158.49 | $223.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $22.39 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $125.89 | Facility | None | $81.28 | $91.20 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $147.91 | Professional | None | $93.33 | $107.15 | $147.91 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $275.42 | Facility | None | $72.44 | $138.04 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $229.09 | Professional | None | $104.71 | $162.18 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $12.88 | $20.42 | $28.84 |
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 $123.03 Median $123.03 Typical High $208.93 | Facility | None | $123.03 | $123.03 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $263.03 | Professional | None | $123.03 | $154.88 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $870.96 | Facility | None | $467.74 | $676.08 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $229.09 | Professional | None | $138.04 | $162.18 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $478.63 | Facility | None | $100.00 | $102.33 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $125.89 | Professional | None | $69.18 | $100.00 | $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 $74.13 Median $112.20 Typical High $181.97 | Professional | None | $74.13 | $112.20 | $181.97 |
15 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 $43.65 Median $69.18 Typical High $95.50 | Professional | 52 · Reduced service | $43.65 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $17.38 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.71 | $13.80 | $19.05 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $134.90 Median $426.58 Typical High $1,230.27 | Facility | 50 · Both sides | $134.90 | $426.58 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $223.87 Typical High $323.59 | Professional | 50 · Both sides | $169.82 | $223.87 | $323.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $120.23 Typical High $199.53 | Professional | 54 · Surgery only | $102.33 | $120.23 | $199.53 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $138.04 Median $229.09 Typical High $269.15 | Professional | 63 · Small infant | $138.04 | $229.09 | $269.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $134.90 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $69.18 Typical High $95.50 | Professional | 52 · Reduced service | $43.65 | $69.18 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $17.38 | $27.54 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.71 | $13.80 | $19.05 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $223.87 Typical High $323.59 | Professional | 50 · Both sides | $223.87 | $223.87 | $323.59 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $151.36 | Professional | 54 · Surgery only | $104.71 | $104.71 | $151.36 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $162.18 |
Where Idaho sits
The same service costs 3.6 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
$138
AK $275KY $75.86
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.