How much rates vary
Facilitymedian $85 · 10th to 90th $23 to $417Professionalmedian $44 · 10th to 90th $27 to $69
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 $22.91 Median $39.81 Typical High $69.18 | Professional | None | $22.91 | $39.81 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.03 Typical High $10.23 | Professional | 55 · Aftercare only | $3.47 | $6.03 | $10.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $24.55 Median $102.33 Typical High $407.38 | Facility | None | $24.55 | $102.33 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $28.84 Median $47.86 Typical High $67.61 | Professional | None | $28.84 | $47.86 | $67.61 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.39 Typical High $6.46 | Professional | 55 · Aftercare only | $2.88 | $3.39 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $22.91 Typical High $30.90 | Facility | None | $20.42 | $22.91 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $37.15 Typical High $52.48 | Professional | None | $26.92 | $37.15 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $22.91 Median $43.65 Typical High $69.18 | Facility | None | $22.91 | $43.65 | $69.18 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $45.71 Typical High $69.18 | Professional | None | $25.12 | $45.71 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.03 Typical High $10.23 | Professional | 55 · Aftercare only | $3.89 | $6.03 | $10.23 |
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 $31.62 Median $31.62 Typical High $61.66 | Facility | None | $31.62 | $31.62 | $61.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $79.43 | Professional | None | $31.62 | $41.69 | $79.43 |
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 $36.31 Median $45.71 Typical High $79.43 | Professional | None | $36.31 | $45.71 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $29.51 Median $30.20 Typical High $281.84 | Facility | None | $29.51 | $30.20 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $18.62 Median $28.18 Typical High $40.74 | Professional | None | $18.62 | $28.18 | $40.74 |
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 $20.42 Median $46.77 Typical High $87.10 | Professional | None | $20.42 | $46.77 | $87.10 |
12 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 $11.48 Median $19.95 Typical High $34.67 | Professional | 52 · Reduced service | $11.48 | $19.95 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $7.94 Typical High $13.80 | Professional | 53 · Discontinued | $4.57 | $7.94 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.98 Typical High $6.92 | Professional | 56 · Pre-op care only | $2.29 | $3.98 | $6.92 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $31.62 Typical High $61.66 | Professional | 54 · Surgery only | $26.30 | $31.62 | $61.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $34.67 Median $67.61 Typical High $83.18 | Professional | 63 · Small infant | $34.67 | $67.61 | $83.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.42 Median $41.69 Typical High $48.98 | Professional | 78 · Unplanned return to OR | $20.42 | $41.69 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $19.95 Typical High $34.67 | Professional | 52 · Reduced service | $13.18 | $19.95 | $34.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $7.94 Typical High $13.80 | Professional | 53 · Discontinued | $5.25 | $7.94 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.98 Typical High $6.92 | Professional | 56 · Pre-op care only | $2.63 | $3.98 | $6.92 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $50.12 | Professional | 54 · Surgery only | $28.84 | $28.84 | $50.12 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $7.24 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.90 Median $30.90 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $30.90 | $30.90 | $53.70 |
Where Idaho sits
The same service costs 3.5 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
$43.65
AK $83.18VA $23.99
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.