How much rates vary
Facilitymedian $135 · 10th to 90th $56 to $380Professionalmedian $71 · 10th to 90th $47 to $120
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 $42.66 Median $70.79 Typical High $107.15 | Professional | None | $42.66 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.47 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $10.47 | $15.85 |
BCBS Idaho Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $199.53 | Facility | None | $64.57 | $112.20 | $199.53 |
BCBS Idaho Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $125.89 | Professional | None | $57.54 | $87.10 | $125.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.71 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $8.71 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $81.28 | Professional | None | $46.77 | $57.54 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $70.79 Typical High $107.15 | Facility | None | $35.48 | $70.79 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $107.15 | Professional | None | $51.29 | $83.18 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.47 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $10.47 | $15.85 |
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 $60.26 Median $60.26 Typical High $114.82 | Facility | None | $60.26 | $60.26 | $114.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $144.54 | Professional | None | $60.26 | $75.86 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Facility | None | $107.15 | $154.88 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $128.82 | Professional | None | $69.18 | $83.18 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $208.93 | Facility | None | $54.95 | $56.23 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $70.79 | Professional | None | $34.67 | $54.95 | $70.79 |
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 $37.15 Median $57.54 Typical High $100.00 | Professional | None | $37.15 | $57.54 | $100.00 |
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 $21.38 Median $34.67 Typical High $53.70 | Professional | 52 · Reduced service | $21.38 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.13 Typical High $21.38 | Professional | 53 · Discontinued | $8.51 | $14.13 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.08 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.27 | $7.08 | $10.72 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $74.13 Median $141.25 Typical High $281.84 | Facility | 50 · Both sides | $74.13 | $141.25 | $281.84 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $158.49 Typical High $186.21 | Professional | 50 · Both sides | $87.10 | $158.49 | $186.21 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $58.88 Typical High $109.65 | Professional | 54 · Surgery only | $51.29 | $58.88 | $109.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $67.61 Median $81.28 Typical High $147.91 | Professional | 63 · Small infant | $67.61 | $81.28 | $147.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $47.86 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $38.90 | $47.86 | $85.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $34.67 Typical High $53.70 | Professional | 52 · Reduced service | $21.38 | $34.67 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.13 Typical High $21.38 | Professional | 53 · Discontinued | $8.51 | $14.13 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.08 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.27 | $7.08 | $10.72 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $114.82 Typical High $181.97 | Professional | 50 · Both sides | $114.82 | $114.82 | $181.97 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $53.70 | $85.11 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $12.02 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $91.20 |
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
$70.79
AK $148KY $39.81
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.