How much rates vary
Facilitymedian $151 · 10th to 90th $74 to $479Professionalmedian $102 · 10th to 90th $68 to $170
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $154.88 | Professional | None | $61.66 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $75.86 Typical High $114.82 | Professional | 54 · Surgery only | $46.77 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.14 Typical High $22.91 | Professional | 55 · Aftercare only | $9.33 | $15.14 | $22.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $407.38 | Facility | None | $79.43 | $154.88 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $173.78 | Professional | None | $83.18 | $109.65 | $173.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $75.86 | $138.04 | $162.18 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.30 Typical High $17.38 | Professional | 55 · Aftercare only | $8.32 | $12.30 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $102.33 | Facility | None | $67.61 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $114.82 | Professional | None | $66.07 | $81.28 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $100.00 Typical High $4,466.84 | Facility | None | $48.98 | $100.00 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $165.96 | Professional | None | $75.86 | $120.23 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $75.86 Typical High $114.82 | Professional | 54 · Surgery only | $46.77 | $75.86 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.14 Typical High $22.91 | Professional | 55 · Aftercare only | $9.33 | $15.14 | $22.91 |
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 $91.20 Median $91.20 Typical High $162.18 | Facility | None | $91.20 | $91.20 | $162.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $204.17 | Professional | None | $91.20 | $114.82 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $120.23 | Professional | 54 · Surgery only | $77.62 | $77.62 | $120.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $512.86 | Facility | None | $275.42 | $389.05 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $186.21 | Professional | None | $100.00 | $120.23 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $316.23 | Facility | None | $77.62 | $77.62 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $102.33 | Professional | None | $50.12 | $77.62 | $102.33 |
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 $56.23 Median $85.11 Typical High $147.91 | Professional | None | $56.23 | $85.11 | $147.91 |
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 $30.90 Median $50.12 Typical High $75.86 | Professional | 52 · Reduced service | $30.90 | $50.12 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.95 Typical High $30.90 | Professional | 53 · Discontinued | $12.30 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.00 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.17 | $10.00 | $15.49 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $229.09 Typical High $616.60 | Facility | 50 · Both sides | $117.49 | $229.09 | $616.60 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $147.91 Typical High $257.04 | Professional | 50 · Both sides | $125.89 | $147.91 | $257.04 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $100.00 Median $173.78 Typical High $208.93 | Professional | 63 · Small infant | $100.00 | $173.78 | $208.93 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $70.79 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $58.88 | $70.79 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $50.12 Typical High $75.86 | Professional | 52 · Reduced service | $30.90 | $50.12 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.95 Typical High $30.90 | Professional | 53 · Discontinued | $12.30 | $19.95 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.00 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.17 | $10.00 | $15.49 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | 50 · Both sides | $165.96 | $165.96 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $17.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $128.82 |
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
$102
AK $204KY $56.23
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.