How much rates vary
Facilitymedian $195 · 10th to 90th $79 to $398Professionalmedian $87 · 10th to 90th $54 to $151
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 $81.28 Median $120.23 Typical High $194.98 | Facility | None | $81.28 | $120.23 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $131.83 | Professional | None | $51.29 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $19.50 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $19.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $181.97 Typical High $389.05 | Facility | None | $79.43 | $181.97 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $165.96 | Professional | None | $72.44 | $114.82 | $165.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.71 Typical High $16.98 | Professional | 55 · Aftercare only | $7.24 | $8.71 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $100.00 | Professional | None | $53.70 | $70.79 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $218.78 Typical High $389.05 | Facility | None | $81.28 | $218.78 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $158.49 | Professional | None | $64.57 | $95.50 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $19.50 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $19.50 |
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 $79.43 Median $79.43 Typical High $151.36 | Facility | None | $79.43 | $79.43 | $151.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $190.55 | Professional | None | $79.43 | $100.00 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $416.87 | Facility | None | $218.78 | $331.13 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $158.49 | Professional | None | $81.28 | $95.50 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $239.88 | Facility | None | $72.44 | $74.13 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $40.74 Median $72.44 Typical High $87.10 | Professional | None | $40.74 | $72.44 | $87.10 |
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 $42.66 Median $69.18 Typical High $123.03 | Professional | None | $42.66 | $69.18 | $123.03 |
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 $39.81 Typical High $66.07 | Professional | 52 · Reduced service | $25.70 | $39.81 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.22 Typical High $26.30 | Professional | 53 · Discontinued | $10.23 | $16.22 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.94 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.13 | $7.94 | $13.18 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $112.20 Median $213.80 Typical High $371.54 | Facility | 50 · Both sides | $112.20 | $213.80 | $371.54 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $213.80 Typical High $251.19 | Professional | 50 · Both sides | $112.20 | $213.80 | $251.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $77.62 Typical High $147.91 | Professional | 54 · Surgery only | $66.07 | $77.62 | $147.91 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $87.10 Median $102.33 Typical High $204.17 | Professional | 63 · Small infant | $87.10 | $102.33 | $204.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $63.10 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $51.29 | $63.10 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $39.81 Typical High $66.07 | Professional | 52 · Reduced service | $25.70 | $39.81 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.22 Typical High $26.30 | Professional | 53 · Discontinued | $10.23 | $16.22 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.13 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.13 | $8.13 | $13.18 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | 50 · Both sides | $134.90 | $134.90 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $104.71 | Professional | 54 · Surgery only | $63.10 | $63.10 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $14.79 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $67.61 | $67.61 | $112.20 |
Where Idaho sits
The same service costs 4.0 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· 12th of 51
$89.13
AK $195KY $48.98
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.