How much rates vary
Facilitymedian $174 · 10th to 90th $72 to $417Professionalmedian $100 · 10th to 90th $59 to $191
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 $100.00 Median $102.33 Typical High $194.98 | Facility | None | $100.00 | $102.33 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $162.18 | Professional | None | $51.29 | $91.20 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $12.59 Typical High $24.55 | Professional | 55 · Aftercare only | $7.76 | $12.59 | $24.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $134.90 Typical High $426.58 | Facility | None | $72.44 | $134.90 | $426.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $204.17 | Professional | None | $66.07 | $141.25 | $204.17 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $6.92 | $17.38 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $109.65 | Facility | None | $72.44 | $81.28 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $125.89 | Professional | None | $58.88 | $89.13 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $234.42 Typical High $380.19 | Facility | None | $85.11 | $234.42 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $199.53 | Professional | None | $61.66 | $107.15 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.59 Typical High $24.55 | Professional | 55 · Aftercare only | $8.13 | $12.59 | $24.55 |
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 $72.44 Median $72.44 Typical High $186.21 | Facility | None | $72.44 | $72.44 | $186.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $234.42 | Professional | None | $72.44 | $91.20 | $234.42 |
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 $83.18 Median $107.15 Typical High $199.53 | Professional | None | $83.18 | $107.15 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $269.15 | Facility | None | $89.13 | $91.20 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $107.15 | Professional | None | $40.74 | $74.13 | $107.15 |
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 $51.29 Median $89.13 Typical High $162.18 | Professional | None | $51.29 | $89.13 | $162.18 |
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 $25.70 Median $42.66 Typical High $81.28 | Professional | 52 · Reduced service | $25.70 | $42.66 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.98 Typical High $32.36 | Professional | 53 · Discontinued | $10.47 | $16.98 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.51 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.13 | $8.51 | $16.22 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $109.65 Median $204.17 Typical High $645.65 | Facility | 50 · Both sides | $109.65 | $204.17 | $645.65 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $120.23 Typical High $302.00 | Professional | 50 · Both sides | $100.00 | $120.23 | $302.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $61.66 | $154.88 | $181.97 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $79.43 Median $93.33 Typical High $251.19 | Professional | 63 · Small infant | $79.43 | $93.33 | $251.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $56.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $46.77 | $56.23 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $42.66 Typical High $81.28 | Professional | 52 · Reduced service | $26.92 | $42.66 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.98 Typical High $32.36 | Professional | 53 · Discontinued | $10.72 | $16.98 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.51 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.37 | $8.51 | $16.22 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $138.04 Typical High $275.42 | Professional | 50 · Both sides | $138.04 | $138.04 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $128.82 | Professional | 54 · Surgery only | $63.10 | $63.10 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $18.62 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $67.61 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $67.61 | $67.61 | $138.04 |
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· 14th of 51
$100
AK $214VA $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.