How much rates vary
Facilitymedian $178 · 10th to 90th $83 to $676Professionalmedian $126 · 10th to 90th $85 to $195
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 $79.43 Median $123.03 Typical High $173.78 | Professional | None | $79.43 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $26.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $83.18 Median $234.42 Typical High $691.83 | Facility | None | $83.18 | $234.42 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $204.17 | Professional | None | $104.71 | $144.54 | $204.17 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $83.18 Typical High $114.82 | Facility | None | $74.13 | $83.18 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $134.90 | Professional | None | $85.11 | $97.72 | $134.90 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $123.03 Typical High $245.47 | Facility | None | $64.57 | $123.03 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $208.93 | Professional | None | $97.72 | $147.91 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $26.30 |
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 $112.20 Median $112.20 Typical High $186.21 | Facility | None | $112.20 | $112.20 | $186.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $234.42 | Professional | None | $112.20 | $141.25 | $234.42 |
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 $125.89 Median $147.91 Typical High $208.93 | Professional | None | $125.89 | $147.91 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $478.63 | Facility | None | $89.13 | $91.20 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $114.82 | Professional | None | $63.10 | $89.13 | $114.82 |
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 $67.61 Median $102.33 Typical High $165.96 | Professional | None | $67.61 | $102.33 | $165.96 |
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 $39.81 Median $61.66 Typical High $87.10 | Professional | 52 · Reduced service | $39.81 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $15.85 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.30 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.94 | $12.30 | $17.38 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $331.13 Typical High $1,047.13 | Facility | 50 · Both sides | $123.03 | $331.13 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $239.88 Typical High $309.03 | Professional | 50 · Both sides | $158.49 | $239.88 | $309.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $104.71 | $162.18 | $190.55 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $125.89 Median $147.91 Typical High $245.47 | Professional | 63 · Small infant | $125.89 | $147.91 | $245.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $87.10 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $72.44 | $87.10 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $61.66 Typical High $87.10 | Professional | 52 · Reduced service | $39.81 | $61.66 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $15.85 | $25.12 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.30 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.94 | $12.30 | $17.38 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | 50 · Both sides | $208.93 | $208.93 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | 54 · Surgery only | $95.50 | $95.50 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $147.91 |
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
$126
AK $257KY $69.18
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.